Renal Artery Stenosis

Renal artery stenosis is a narrowing of the arteries that carry blood to one or both the kidneys. Most often seen in older people with atherosclerosis (hardening of the arteries), renal artery stenosis can worsen over time and often leads to hypertension (high blood pressure) and kidney damage. The body senses that there is less blood reaching the kidneys and misinterprets that as the body having low blood pressure. This signals the release of hormones from the kidney that leads to an increase in blood pressure. Over time, renal artery stenosis can lead to kidney failure.

Causes and Symptoms

Most renal artery stenosis is caused by atherosclerosis (hardening and narrowing of blood vessel walls from the inside) like the process that occurs in blood vessels in the heart and other parts of the body.

Risk factors for atherosclerosis include:

  • high cholesterol levels
  • high blood pressure
  • age
  • cigarette smoking
  • diabetes

Renal artery stenosis may cause no signs or symptoms until the condition reaches an advanced state. Most people with renal artery stenosis have no signs and symptoms. The condition may be discovered incidentally during testing for some other reason. Your doctor may also suspect a problem if you have:

  • High blood pressure that begins suddenly
  • High blood pressure that begins before the age of 30 or after 55 years of age
Diagnosis and Treatment

Blood tests: Screening blood tests may be done as part of the general evaluation of high blood pressure and may include a complete blood count, electrolytes, kidney function tests and a urinalysis.

Imaging: Renal artery narrowing can be detected with ultrasound or computerized tomography angiography or arteriography.

Treatment for renal artery stenosis may involve lifestyle changes, medication or a procedure. Sometimes a combination of treatments is the best approach. Depending on your overall health and symptoms, observation may be all that you need.