Hypervolemia

Overview

What is hypervolemia?

Hypervolemia is a condition where your body has too much fluid. Another name for hypervolemia is “fluid overload” or “volume overload.”

Your body is made up of 50% to 60% fluid, which includes water, blood and lymphatic fluid. Fluid keeps your organs functioning, especially by moving blood through your circulatory system. If you have too much fluid in your body, you could experience swelling, high blood pressure and potential heart problems.

How common is hypervolemia and who does it affect?

Hypervolemia can affect anyone. It can occur as a symptom for:

  • Heart or kidney conditions.
  • People who are pregnant.
  • People who experience hormonal changes.
  • People who have too much salt (sodium) in their diet.

The exact rate of occurrence is unknown because mild cases of hypervolemia resolve on their own, while severe cases are often a symptom of an underlying condition.

How does hypervolemia affect my body?

When you have hypervolemia, you could experience some discomfort, like swelling, that can prevent you from going about your daily activities. If your symptoms are mild, you can elevate the swollen part of your body while you rest, like putting your swollen ankle on a pillow while laying down. Or, you can try wearing compression stockings. Contact your healthcare provider if symptoms get worse or if swelling spreads to another part of your body.

Symptoms and Causes

What are the signs and symptoms of hypervolemia?

Symptoms of hypervolemia range in severity for each person and could include:

  • Swelling in an area of your body, most often your arms and legs, where it appears larger than it was a day ago.
  • Bloating in your stomach.
  • Mild discomfort like cramping or a headache.
  • Quick weight gain.

Severe symptoms of hypervolemia that need immediate treatment include:

If you have any serious symptoms, visit the emergency room immediately.

What causes hypervolemia?

Several factors could cause hypervolemia including too much salt in your body, an underlying condition or hormonal changes.

Salt (sodium)

Too much salt (sodium) in your body causes hypervolemia. Salt is an essential mineral in your body. Your body manages the amount of salt you eat with water. If you eat food that contains too much sodium, your body will use water to balance it back to a normal level. This is why you might feel thirsty after eating a lot of salty foods.

If you receive intravenous (IV) fluids after surgery or if you’re dehydrated, some fluids contain sodium. It’s possible to experience symptoms of hypervolemia while getting fluids from an IV because your body’s sodium levels aren’t balanced.

Underlying condition

Some conditions affect how your body manages fluid. Common conditions that could cause hypervolemia as a symptom include:

Certain medicines to treat these conditions may cause hypervolemia as a side effect, especially drugs to treat blood pressure or pain management.

Treating or managing the underlying condition could resolve hypervolemia and prevent it from coming back.

Hormonal changes and pregnancy

Changes to your hormones can cause hypervolemia, most often during your period or during pregnancy when your body retains more sodium and water. People who are pregnant often experience swelling in their legs or ankles because the uterus puts pressure on the blood vessels in the body’s lower trunk. This pressure prevents fluid from moving freely through your circulatory system.

Why are the kidneys important to regulate fluid in my body?

Your kidneys help your body remove excess fluid through your urinary system, which leaves your body as pee (urine). Your kidneys function to balance the amount of fluid in your body, either by removing it or reusing it. Your kidneys are filters. They separate water and electrolytes (essential minerals including sodium and potassium) from waste. Waste leaves your body and the fluid that’s remaining gets recycled into your circulatory system to help your cells and organs function.

Diagnosis and Tests

How is hypervolemia diagnosed?

Your healthcare provider will offer a physical exam to check your symptoms. They may also request a test to monitor the sodium levels in your blood and urine. Your provider may also test the amount of blood in your body with a blood volume test, to see if it’s too high. A high test result leads to a hypervolemia diagnosis.

If your provider suspects that your hypervolemia diagnosis is a symptom of an underlying condition, they will offer additional blood or imaging tests to diagnose the underlying condition.

If you have an underlying condition that puts you at risk for hypervolemia, weighing yourself regularly can help you detect hypervolemia early, as you’ll experience rapid weight gain.

Management and Treatment

How is hypervolemia treated?

Treatment for hypervolemia varies depending on the cause but focuses on reducing the amount of fluid in your body.

The most effective treatment for hypervolemia is to treat or manage the underlying cause of the condition to stop symptoms and prevent them from returning in the future.

Other treatment options for hypervolemia include:

  • Taking diuretics: Drugs to reduce the amount of fluid in your body.
  • Reducing the amount of salt in your diet.
  • Limiting the amount of fluid you drink.
  • Undergoing dialysis or paracentesis: Removing excess fluid from your body.

Can I drink water if I have hypervolemia?

Yes, you should still drink water if you have hypervolemia because water is an essential part of your body and helps keep your organs functioning. Do limit the amount of water you drink. Keep track of your fluid intake and ask your healthcare provider for a recommendation on the amount you should consume each day.

How soon after treatment will I feel better?

Depending on the type of treatment your provider recommends, symptoms could fade within 24 hours after treatment or up to a couple of weeks. Your provider will monitor your progress and adjust your treatment as necessary to reduce the number of symptoms you experience.

Prevention

How can I prevent hypervolemia?

While you can’t prevent all cases of hypervolemia, you can take steps to reduce your risk by:

  • Eating a low sodium diet.
  • Monitoring the amount of fluids you drink each day.
  • Keeping track of how much you weigh to check for sudden changes.
  • Managing or treating any underlying medical conditions that you have.

Outlook / Prognosis

What can I expect if I have hypervolemia?

Having too much fluid in your body can cause serious side effects, so it is important to get the treatment you need to prevent long-term damage. With early detection and treatment, the prognosis is good for people diagnosed with hypervolemia. When hypervolemia is a symptom of an underlying condition, the prognosis is dependent on the effectiveness of that condition’s treatment.

Talk to your provider if you have questions about your diagnosis and whether or not you need to make any lifestyle changes, like limiting the amount of salt in your diet or monitoring the amount of water you drink.

How long does hypervolemia last?

Mild cases of hypervolemia can go away on their own within a few days, but it’s best to check with your provider to see whether or not you need treatment. More serious cases might have a longer recovery time, especially if your case is a symptom of an underlying medical condition. Treating the underlying condition that caused hypervolemia helps you get back on your feet sooner, but you could experience symptoms for a few weeks after treatment begins.

Living With

When should I see my healthcare provider?

If you experience symptoms of hypervolemia, talk with your provider. Early diagnosis and treatment for hypervolemia lead to the best outcome and reduces the amount of discomfort you might feel because of too much fluid in your body.

When should I go to the ER?

If you experience severe symptoms that make it difficult for you to breathe, your heart beats abnormally or you experience severe pain, visit the emergency room immediately.

What questions should I ask my doctor?

  • What caused my diagnosis?
  • How much water can I drink each day?
  • When and for how long do I need to take diuretics?
  • How can I manage my underlying condition to prevent hypervolemia from returning?

Frequently Asked Questions

What is the difference between hypervolemia and hypovolemia?

Hypervolemia and hypovolemia are conditions that identify the amount of fluid or blood is in your body. The root “hyper” in hypervolemia means “over” and “hypo” in hypovolemia means “under.” “Vol” refers to volume. If you have hypervolemia, you have too much fluid in your body. If you have hypovolemia, you don’t have enough fluid in your body.

A note from Cleveland Clinic

Hypervolemia can temporarily make you feel uncomfortable. When you start to experience symptoms, reach out to your provider to see if you need treatment. While many mild cases can go away on their own, persistent and untreated hypervolemia can be dangerous. Take steps to reduce your risk of getting hypervolemia by eating a diet low in sodium (salt) and managing any medical conditions that you have.

Last reviewed by a Cleveland Clinic medical professional on 05/10/2022.

References

  • Merck Manual. Volume Overload. (https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/fluid-metabolism/volume-overload) Accessed 5/10/2022.
  • National Library of Medicine. Fluid imbalance. (https://medlineplus.gov/ency/article/001187.htm) Accessed 5/10/2022.
  • National Kidney Foundation. Fluid Overload in a Dialysis Patient. (https://www.kidney.org/atoz/content/fluid-overload-dialysis-patient) Accessed 5/10/2022.
  • Segal A. Disorders of Extracellular Volume: Hypovolemia and Hypervolemia. (https://accessmedicine-mhmedical-com.ccmain.ohionet.org/content.aspx?bookid=2287&sectionid=177426080) Lerma EV, Rosner MH & Perazella MA, eds. CURRENT Diagnosis & Treatment: Nephrology & Hypertension, 2e. New York: McGraw Hill; 2017. Accessed 5/10/2022.
  • StatPearls. Plasma Volume Study. (https://www.statpearls.com/ArticleLibrary/viewarticle/27303) Accessed 5/10/2022.

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