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As a part of the initial work-up before diagnosing lymphedema, it may be necessary to exclude other potential causes of lower extremity swelling such as renal failure, hypoalbuminemia, congestive heart-failure, protein-losing nephropathy, pulmonary hypertension, obesity, pregnancy and drug-induced edema.
Lower extremity swelling can be caused by trapped fluid. Causes of trapped fluid include: 1  acute kidney failure. 2  cardiomyopathy (disease of the heart tissue). 3  chronic kidney failure. 4  heart failure. 5  hormone therapy. 6  lymphedema (blockage in the lymph system). 7  nephrotic syndrome (damage to the vessels in the kidneys).