Major causes of edema by primary mechanism

Increased capillary hydraulic pressure

Increased plasma volume due to renal sodium retention

Heart failure, including cor pulmonale

Primary renal sodium retention

Renal disease, including the nephrotic syndrome

Drugs:* Nonsteroidal antiinflammatory drugs (NSAIDs), glucocorticoids, fludrocortisone, thiazolidinediones (glitazones), insulins, estrogens, progestins, androgens, testosterone, aromatase inhibitors, tamoxifen; and by multiple mechanisms: vasodilators (hydralazine, minoxidil, diazoxide) and calcium channel blockers (particularly dihydropyridines [ie, amlodipine, nifedipine]); also refer to "Arteriolar vasodilation" below

Refeeding edema

Early hepatic cirrhosis

Pregnancy and premenstrual edema

Idiopathic edema, when diuretic induced

Sodium or fluid overload: Parenteral antibiotics or other drugs with large amounts of sodium, sodium bicarbonate, or excessive or overly rapid fluid replacement

Venous obstruction or insufficiency

Cirrhosis or hepatic venous obstruction

Acute pulmonary edema

Local venous obstruction

Venous thrombosis

Venous stenosis

Chronic venous insufficiency – Post-thrombotic syndrome

Arteriolar vasodilation

Drugs:* Frequent – Vasodilators (hydralazine, minoxidil, diazoxide), dihydropyridine calcium channel blockers; less frequent – alpha1 blockers, sympatholytics (ie, methyldopa), nondihydropyridine calcium channel blockers^[1]

Idiopathic edema

Hypoalbuminemia

Protein loss

Nephrotic syndrome

Protein-losing enteropathy

Reduced albumin synthesis

Liver disease

Malnutrition

Increased capillary permeability

Idiopathic edema

Burns

Trauma

Inflammation or sepsis

Allergic reactions, including certain forms of angioedema

Acute respiratory distress syndrome

Diabetes mellitus

Interleukin 2 therapy

Malignant ascites

Lymphatic obstruction or increased interstitial oncotic pressure

Lymph node dissection

Nodal enlargement due to malignancy

Hypothyroidism

Malignant ascites

Other drugs* (uncertain mechanism)

Anticonvulsant: Gabapentin, pregabalin

Antineoplastic: Docetaxel, cisplatin

Antiparkinson: Pramipexole, ropinirole

* Patients with decreased cardiac output, preexisting renal insufficiency, and/or receiving higher doses are more likely to experience edema and edema-associated adverse events. This is not a complete list of drugs associated with edema. For additional information, refer to the Lexicomp individual drug monographs included with UpToDate.

Reference:

Messerli FH. Vasodilatory edema: A common side effect of antihypertensive therapy. Curr Cardiol Rep 2002; 4(6):479.

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Major causes of edema by primary mechanism