Hi,
Based on the history you have shared, the leg swelling can be due to all three factors in his case.
Heart disease which may need adjustment of treatment and addition of those drugs which can help his heart to pump more, and is not contraindicated in his kidney disease.
Second issue is pulmonary
hypertension, for which again drugs which decrease
pulmonary artery pressure like bosonton etc may be needed.
Third is kidney disease, in which if he is losing protein like
albumin in urine it may cause swelling of legs so in such case drugs that lower the protein leakage may be needed.
These drugs are interrelated and must be prescribed with caution as treating one can disturb the other disease so a close liason with a cardiologist and a
nephrologist is a must.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr. Saddiq Ulabidin, General & Family Physician