Definition

Renovascular hypertension is a form of high blood pressure.

Causes

The kidneys control blood pressure. If blood cannot get to the kidneys, certain hormones get out of balance. The imbalance makes the blood pressure higher.

Blood flow can be disrupted by:

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

High blood pressure is a leading cause of stroke, heart attack, and kidney failure.

Risk Factors

Risk is higher if you:

• Are over 60 years old
• Have high blood pressure
• Have blocked blood vessels
• Have diabetes
• Smoke
• Have high cholesterol
• Or someone in your family has kidney or heart problems

Symptoms

Most people don't have symptoms. If they appear, you may have:

• High blood pressure—can be hard to control
• Pain in your back or side
• Blood in your urine
• Breathing problems from fluid buildup in the lungs
• Weight gain
• Fluid buildup in your legs, ankles, or feet

Diagnosis

The doctor will ask about your symptoms and health history. You may also have:

• A physical exam
• Blood pressure readings
• Blood and urine tests to look for certain proteins or other markers
• Imaging tests:
  • Renal ultrasound
  • CT angiography
  • MR angiography
  • Angiography

Treatment

Care involves lowering blood pressure. This will help lower stress on the kidneys. Care may involve:

• Quitting smoking, getting routine exercise, or eating better foods
• Medicines to lower blood pressure
• Surgery such as:
  • Percutaneous angioplasty—using a balloon or stent to open the artery
  • Bypass—rebuilding a blood vessel by going around the block
  • Remove one or both kidneys— nephrectomy

Prevention

To help keep your kidneys healthy:

• Talk to your doctor about quitting smoking.
• Stay in a healthy weight range.
• If you have a health problem that harms your kidneys, follow your care plan.