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Overview
Renal artery stenosis refers to a blockage or narrowing of the renal (kidney) artery. The renal artery supplies blood to the kidneys. Renal artery stenosis limits blood flow to the kidneys and can cause high blood pressure or kidney failure. Renal artery stenosis causes 5% of all high blood pressure.
Causes of Renal Artery Stenosis
Most blockages are caused by atherosclerosis or a build up of cholesterol. There are many risk factors for atherosclerosis such as getting older, high cholesterol, high blood pressure, diabetes, smoking, obesity, sedentary lifestyle, stress, and family history. A rarer cause of stenosis, usually seen in young women, is fibromuscular dysplasia. This is a growth of fibrous tissue in the artery.
Symptoms of Renal Artery Stenosis
Most patients do not have symptoms. Your doctor may suspect stenosis if you have heart disease or other atherosclerosis, severe high blood pressure (often > 160/90), abnormal blood tests suggesting abnormal kidney function, or episodes of congestive heart failure with fluid building up in the lungs.
Diagnostic Tests
Your doctor may detect a stenosis if he hears a whoosing sound when listening to your abdomen over the kidney arteries with a stethoscope. Simple non-invasive tests include: ultrasound, CT scan, or magnetic resonance angiogram to produce images of the kidney arteries and kidney. A more invasive, but more accurate, test is an angiogram where a doctor inserts a catheter into the leg artery and injects dye into the kidney artery.
Treatment Options
Treatment depends on the cause of the disease, its severity, and associated problems or symptoms that you may have. Your doctor will prescribe medications to treat blood pressure, cholesterol, and diabetes. He will also recommend diet, stopping smoking, and exercise. For many patients, this may sufficient and your doctor will follow your blood pressure and kidney function. Patients with severe high blood pressure not controlled with medications or patients with abnormal kidney function may need more invasive treatments, usually angioplasty with stent or rarely surgery. Angioplasty is a minimally invasive procedure where the doctor advances a balloon catheter to the blockage and inflates it to open the blockage. He then places a stent, a metal coil, at the blockage to hold it open.
Additional Information
www.cardiosmart.org
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