Renovascular Hypertension

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.

Blood flow can be disrupted by:

• Renal artery stenosis —The arteries of the kidneys become narrow
• Atherosclerosis —Plaque builds up and blocks blood flow
• Fibromuscular dysplasia—Muscle and tissue thicken on the artery wall and harden into rings that block blood flow
• Structural problems—Some may be present at birth

Risk Factors

This problem is more common in people over 60 years of age. Other things that may raise the risk are:

• High blood pressure
• Blocked blood vessels
• Diabetes
• Smoking
• High cholesterol
• Having other family members with kidney or heart problems

Symptoms

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

• Pain in the back or side
• Bloody urine
• Breathing problems from fluid buildup in the lungs
• Fluid buildup in the legs, ankles, or feet
• Weight gain

Diagnosis

The doctor will ask about symptoms and health history. 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 this health problem.

Images may be taken. 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 .

Lowering blood pressure will ease stress on the kidneys. Options are:

• Lifestyle changes, such as not smoking, exercising, and eating a healthful diet
• Medicines to lower blood pressure
• Surgery, such as:
  • Percutaneous angioplasty—using a balloon or stent to open the artery and improve blood flow
  • Bypass—rebuilding a blood vessel by going around the blockage
  • Nephrectomy—Removal of one or both kidneys

Prevention

The risk of this problem may be lowered by:

• Not smoking
• Reaching or maintaining a healthy weight