Brief Answer:
An immediate consideration to change the actual therapy is necessary.

Detailed Answer:
Hello!

Welcome on HCM!

I passed carefully through your concern and would like to explain that both Amlodipine and Diltiazem are well-known to cause lower limbs edema: Amlodipine use may be associated with edema in around 10% of patients, Diltiazem even more (up to 10%).

From the other side, there are commonly no medically justified reasons to prescribe concomitant Amlodipine and Diltiazem (two calcium channel blockers) in hypertensive patients.

Several other anti-hypertensive schemes may be used instead.

Coming to this point, I would advise to seriously consider stopping the actual anti-hypertensive drugs after consulting as soon as possible with his attending (prescribing) doctor.

It is quite possible that after withdrawing from one of them (more rationally Diltiazem), it become apparent a decrease or even disappearance of limbs edema.

Nevertheless, considering the fact your son is a patient of young age and has previous history of kidney disfunction, it is necessary a comprehensive clinical investigation just to confirm of exclude possible kidney or other organs adverse implication in the actual clinical symptomatology.

For such purpose some medical tests are recommended as follows:

- Complete blood count,
- BUN & creatinine,
- Blood electrolytes level,
- Arterial blood gas analysis,
- Thyroid hormones level,
- Liver function tests,
- Plasma rennin activity,
- Plasma Aldosterone levels,
- Resting ECG,
- Cardiac ultrasound,
- Plasma protein level,
- Plasma cortisol level,
- Fasting blood glucose,
- Plasma uric acid level

You should discuss with his attending doctor on the above mentioned issues.

Hope to have been helpful to you!

In case of any further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri

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