The kidneys depend on an adequate flow of blood to perform their basic functions of filtering fluid through the body. With a lack of blood traveling through the body due to congestive heart failure, fluid can build up in the body known, as water retention. This water retention can ultimately lead to swollen ankles, legs, and abdomen. This leads to a puffy or bloated appearance in many of the extremities as well as other organs in the body putting vital bodily functions at risk. In severe cases, fluid can lead to the enlargement of the liver resulting in impaired liver function.