Swelling and Cardiothoracic Ratio


My mother has been having swelling in her feet. Her CRT ratio is at 47.4%.

  1. Does swelling automatically mean that you need to lower your dry weight?
  2. My understanding is that a CRT ration under 50% is considered normal. So does that mean that
    she does not need to lower her dry weight even though there is swelling?
  3. I am loathe to lower the dry weight since she has problems with low blood pressure during dialysis.

Thank you.

This is far too hard to answer without knowing much, much more about your mother than I could know by means of an internet question, even if I were to ask for more information. So, I am sorry to disappoint but I dont think I could do justice to your mother by trying this one.

In broad terms - and the reason for my reticence - no, swelling of her ankles may be caused by many things. One of these - and perhaps the most common - would be fluid overload and a need to lower dry weight but it is by no means the only possibility and her physician is the appropriate person to advise this. See her doctor for advice.

A ‘normal’ CRT is about the ‘bluntest’ possible tool to assess the heart that I know. There are far more effective and sophisticated ways to know whether her heart is at issue … and I would not walk away content just because the CRT is <50%. Again, she needs a cardiological assessment to decide that - not just a plain xray and a pat on the back that all is well because the CRT is normal.

Though my guess might be that her dry weight does need to come down, this is a guess from far away, made with little or no information and absolutely no knowledge of your mother as an individual and/or of her past and present medical state. A low BP during dialysis also has many causes and only her physician can know all of these issues and deal with them wisely.

Sorry to be such a dead loss to you on this one Muraiken but, this time, your mother needs a medical review, not an internet question.