Renal Artery Stenosis

What is Renal Artery Stenosis?

Renal artery stenosis is a narrowing of the blood vessels that carry blood to the kidneys. Since less blood is reaching the kidneys the body misinterprets that as the body having low blood pressure and compensates by releasing hormones that increase the body’s blood pressure. Over time this cycle of less blood getting to the kidneys and high blood pressure leads to kidney failure. 

Who is at risk for Renal Artery Stenosis?

Narrowing and hardening of blood vessels also known as atherosclerosis is most common in the elderly. Other risk factors include female gender, chronic kidney disease, diabetes, tobacco use, and having an abnormal cholesterol level. 

What are the symptoms of Renal Artery Stenosis?

The primary symptom of renal artery stenosis is high blood pressure that is resistant to treatments with 3 or more drugs. Additionally, when treatment with an ACEi type drug that is supposed to protect the kidneys leads to acute kidney injury, a diagnosis of renal artery stenosis is to be suspected. 

How Renal Artery Stenosis is Diagnosed?

Blood tests will confirm abnormal kidney function and a doppler ultrasound with show a reduction in blood flow to the kidneys. The best way to diagnose renal artery stenosis is a renal catheter arteriography where a wire is inserted through a large artery in the groin, a dye is injected and an x-ray is taken of the arteries. 

How is Renal Artery Stenosis treated?

Renal Artery Stenosis can be treated medically and surgically. Drugs such as ACEi and ARBs can be used for one-sided stenosis however if both kidneys are affected surgery is usually indicated. The definitive management is a surgery where a bypass is performed so blood can get to the kidneys, also stent can be placed to help open the arteries this is usually done if there is over an 80% blockage or patients lab value of creatinine is greater then 4.0. 

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