Renal Artery Stenosis

Renal artery stenosis is the narrowing of kidney arteries. This condition may cause high blood pressure and may eventually lead to kidney failure.

Symptoms

You may not notice any symptoms. If you have high blood pressure, the first sign that you may have renal artery stenosis is that your blood pressure may become worse or the medications that you take to control your high blood pressure may not be as effective.

Causes

Hardening of the arteries with atherosclerosis causes renal artery stenosis. Smoking, obesity, advanced age, high cholesterol, diabetes, and a family history of cardiovascular disease are factors that may increase your chances for developing atherosclerosis.

Diagnosis

  • Using ultrasound, the physician can locate narrow areas inside your arteries and also determine the size of your kidney
  • Angiography, which is more invasive, can locate a narrowing or blockage and can measure blood flow
  • Spiral computed tomography (CT) scan, which creates detailed
    three-dimensional images
  • Magnetic resonance angiography (MRA), which uses magnetic fields and radio waves to produce three-dimensional images of your arteries.

Treatment

Angioplasty and stenting

If your renal artery is partially or completely blocked, the physician may recommend a procedure called angioplasty and stenting. To perform this procedure, the physician inserts a catheter through a small puncture site, or sometimes a small incision, and guides it through the blood vessels to your renal artery. The catheter carries a tiny balloon that inflates and deflates, flattening the plaque against the walls of the artery. Next, the physician may insert a tiny metal-mesh tube called a stent in the artery to hold it open. This procedure, when needed, is often performed at the time of angiography.

Surgery

Two surgical procedures that your physician may use to treat renal artery stenosis are endarterectomy and surgical bypass. In a renal endarterectomy, a vascular surgeon removes the inner lining of your renal artery, which contains the plaque. This procedure removes the plaque and leaves a smooth, wide-open artery.

Bypass surgery creates a detour around the narrowed or blocked sections of your renal artery. To create this bypass, a vascular surgeon connects one of your veins or a tube made from man-made materials, called a bypass graft, above and below the area that is blocked. This creates a new path for your blood to flow to your kidneys.

Risks of Operation

With endovascular procedures there are chances of bleeding, infection, risk of renal failure from IV dye administration, risk of failure of stenting. The open renal artery operations carry a risk of bleeding, infection, risk of injury to other organs, risk of renal failure, risk of multi organ system failure, risk of myocardial infarction and a small risk of death.