Renal Artery Stenosis

Causes

The kidneys control blood pressure. If blood cannot get to the kidneys, then some hormones get out of balance. This makes blood pressure higher.

The two most common causes are:

• Atherosclerosis —plaque builds up in the arteries and blocks blood flow
• Fibromuscular dysplasia—muscle and tissue thicken on the artery wall and harden into rings that block blood flow

Risk Factors

Things that may raise the risk of renal artery stenosis are:

• High blood pressure
• A blocked blood vessel in another part of the body
• Past stroke or heart attack
• Smoking
• Diabetes
• High cholesterol

Symptoms

Most people do not have symptoms. Those who do may have:

• Headache
• Lightheadedness
• Problems breathing
• Chest pain

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. It will include a blood pressure check.

Blood and urine tests will be done to look for certain proteins and other things that point to renal artery stenosis.

Pictures may be taken of the kidneys. This can be done with:

• Renal ultrasound
• CT angiography
• MR angiography
• Angiography

Treatment

The goal of treatment is to lower blood pressure. Untreated high blood pressure can lead to stroke, heart attack, and kidney failure. Options are:

• Lifestyle changes, such as regular physical activity, eating a healthful diet, and not smoking
• Medicines to lower blood pressure
• Surgery, such as:
  • Percutaneous angioplasty—uses a balloon or stent to open the artery and improve blood flow
  • Bypass—rebuilds a blood vessel by going around the blockage
  • Nephrectomy—removes one or both kidneys

Prevention

There are no known methods to prevent renal artery stenosis.