Renal artery disease, also named renal artery stenosis, may occur when the arteries
that supply blood and oxygen to the kidneys become stiff and narrow. In this
case, the kidney cannot receive enough blood flow to function properly. It may
cause high blood pressure and even kidney failure.
Mostly, renal artery disease affects older
people with atherosclerosis. In younger adults, women are more likely to get
the condition than men are. According to statistics, renal artery disease accounts
for about 1% of mild to moderate cases of high blood pressure.
In more than 90% of cases, renal artery disease is caused by atherosclerosis, meaning hardening of the arteries. Atherosclerosis occurs due to the buildup of fatty deposits or plaques along the artery wall. As the plaques accumulate, they can narrow renal arteries and finally block the blood flow to the kidneys.
Another relatively rare cause for renal
artery disease is fibromuscular dysplasia. In this condition, the muscle in the
artery wall grows abnormally and leaves limited space for the blood flow.
Without enough blood supply, kidney damage and failure may occur.
Risk factors for developing renal artery
- Older age
- Female gender
- High blood pressure
- Medical conditions, such as other vascular diseases, chronic kidney disease or diabetes
- A family history of early heart disease
- Lack of exercise
In mild conditions, renal artery stenosis may cause no signs or symptoms. Most patients with the disease are asymptomatic and they may discover the condition incidentally during imaging tests for some other reason. General signs and symptoms that can help you notice the disorder include:
- High blood pressure (hypertension)
- Episodes of fluid retention
- Congestive heart failure
- Shortness of breath
First, your doctor would conduct a physical
examination. During the exam, he or she will ask about your medical history and
listen through a stethoscope over the kidney areas for sounds that may mean the
artery to your kidney is narrowed. Tests can be helpful in diagnosing renal
artery disease and ruling out other suspicious conditions. These tests include:
- Blood tests and urine tests to evaluate kidney function and measure
the levels of hormones that regulate blood pressure
- Doppler ultrasound to help your doctor see the arteries and kidneys
and check their function
- Magnetic resonance arteriogram (MRA) and computed tomographic
angiography (CTA), which use a special dye to produce a 3D image of the kidney
and its blood vessels
- Renal arteriography, a special type of X-ray exam to help your
doctor find the blockage in the renal arteries
Treatment options for renal artery disease
are the combination of medication, lifestyle changes or a procedure.
Medication is mainly used to treat high blood pressure associated with renal
artery disease. They include:
- Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) to help relax blood vessels and block the formation of angiotensin II in the body, which narrows blood vessels
- Diuretics, also known as water pills, to help your body eliminate excess sodium and water
- Beta blockers and alpha-beta blockers, which may make your heart beat slowly and less forcefully or widening (dilating) your blood vessels
- Calcium channel blockers to relax blood vessels
Lifestyle changes that you can do to reduce
blood pressure include:
- Maintaining a healthy weight or lose weight if you’re overweight
- Eating healthy foods
- Limiting salt in your diet
- Doing more exercises
- Reducing your stress levels
- Avoid smoking
For some people with uncontrolled high
blood pressure and severe complications, they can choose surgical treatment. Procedures to treat renal artery stenosis may
- Renal angioplasty and stenting
In this procedure, doctors open the
narrowed renal artery wider and place a device inside your blood vessel to hold
the walls of the vessel open and allows for better blood flow.
- Renal artery bypass surgery
During a bypass procedure, doctors graft a substitute blood vessel to the renal artery to make a new route for blood to reach your kidneys. Sometimes this is done by connecting the renal artery to a vessel from somewhere else, such as the liver or spleen.
Keywords: renal artery disease; renal artery stenosis.