CRDAMC Homepage | CRDAMC Library Phone #: (254) 288-8366 | CRDAMC Library Fax #: (254) 288-8368

Search Health Library

Renal Artery Stenosis

Definition

Renal artery stenosis a narrowing of one or both of the main arteries supplying the kidney. This causes a decrease in blood flow to 1 or both kidneys. The kidneys filter and remove waste from the blood.

The Kidney and its Main Blood Vessels

Copyright © Nucleus Medical Media, Inc.

Causes    TOP

Each kidney is capable of regulating the body’s blood pressure to assure that each organ has an adequate supply of oxygenated blood. Stenosis activates a cascade of hormones known as the renin-angiotensin system. This pattern increases blood pressure. High blood pressure is a leading cause of stroke and heart attack.

The 2 most common causes of renal artery stenosis are:

  • Atherosclerosis—Fatty plaque builds up in the arteries and blocks blood flow to the kidneys. This occurs mainly in men over 50 years old.
  • Fibromuscular dysplasia—An inherited disorder where muscle and fibrous tissue of the renal artery wall thicken and harden into rings that block blood flow to the kidneys. This occurs mainly in young women in their 30s.

Risk Factors    TOP

Factors that may increase your chance of renal artery stenosis include:

Symptoms    TOP

Most people with renal artery stenosis have no symptoms. In those who have them, symptoms may include:

  • Fluid retention
  • Shortness of breath
  • Headaches
  • Ankle swelling

If both renal arteries are blocked, kidney failure occurs.

Diagnosis    TOP

You will be asked about your symptoms and medical history. A physical exam will be done. If you have elevated blood pressure, a search for its cause can involve many different tests. Unless there is a specific reason to suspect renal artery stenosis, it may not be considered at first.

Repeat blood pressure measurements may be done.

Your bodily fluids may be tested. This can be done with:

  • Blood tests
  • Urine tests

Imaging tests may be done to evaluate the kidneys. These may be done with:

Your heart's electrical activity may be measured. This can be done with an electrocardiogram (EKG).

Treatment    TOP

Talk with your doctor about the best treatment plan for you. If there is significant stenosis and you are healthy, repairing the renal artery may be considered before medical treatment. Treatment options include:

Medication

Standard treatment for high blood pressure may be enough if blood pressure can be controlled and the kidneys are functioning well enough. There are many medications that lower blood pressure. You may need several to achieve adequate control. These medications are effective in people who have one blocked renal artery. ACE inhibitors should not be used if hypertension is caused by renal artery stenosis of both kidneys.

Percutaneous Angioplasty

A thin tube is threaded into the renal artery from a puncture in your groin. The tube includes a balloon, laser, or other device that will open the narrowed artery.

Vascular Surgery    TOP

If angioplasty cannot be done on the artery, a surgeon may decide to repair the condition through an incision in your abdomen.

Nephrectomy     TOP

Nephrectomy is an option if the affected kidney has been so damaged that it no longer works, but still causes high blood pressure. Nephrectomy is a procedure to remove part or all of the kidney.

Prevention    TOP

Renal artery stenosis is an unusual cause of hypertension, but an important one because it is curable. The best way to detect hypertension is to have routine blood pressure measurements.

You can also prevent atherosclerosis by exercising regularly, eating a heart healthy diet, quitting smoking, and drinking less alcohol.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov
National Kidney Foundation
http://www.kidney.org

CANADIAN RESOURCES:

Kidney Foundation of Canada
http://www.kidney.ca

References:

Balk E, Raman G, Chung M, et al. Effectiveness of management strategies for renal artery stenosis: A systematic review. Ann Intern Med. 2006;145(12):901-912.
Krumme B, Donauer J. Atherosclerotic renal artery stenosis and reconstruction. Kidney Int. 2006;70(9):1543-1547.
Renal artery stenosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated August 29, 2016. Accessed September 26, 2016.
Zeller T. Renal artery stenosis: Epidemiology, clinical manifestation, and percutaneous endovascular therapy. J Interv Cardiol. 2005;18(6):497-506.
Last reviewed June 2016 by Adrienne Carmack, MD
Last Updated: 5/28/2014

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.

Health Library: Editorial Policy | Privacy Policy | Terms and Conditions | Support
36000 Darnall Loop Fort Hood, Texas 76544-4752 | Phone: (254) 288-8000