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Renal Artery Stenosis

Renal artery stenosis is the condition of the kidney arteries in which they become narrow. This condition is most often observed in the older population who are suffering from atherosclerosis in which their arteries harden. Renal artery stenosis can worsen in patients over time and can often lead to hypertension and kidney damage. In this condition, the body senses less amount of blood reaching the kidneys and misinterprets that as a sign of low blood pressure. This causes signals to be sent to release hormones from the body to increase blood pressure. Over time, this leads to kidney failure. 

Causes

In most cases, renal artery stenosis is caused by atherosclerosis. In atherosclerosis, narrowing of the arteries is caused due to accumulation of plaque, which is made up of fats, cholesterol, and other material built upon the walls of the blood vessels, including those leading to the kidneys. 

In rare cases, renal artery stenosis can be caused by a condition known as fibromuscular dysplasia. In this condition, the cells in the walls of the arteries undergo abnormal growth. Fibromuscular dysplasia is more commonly observed in women and young people.

Risk Factors

  • Renal artery stenosis is commonly diagnosed in patients who are undergoing a diagnosis for another medical problem. Some of the risk factors for renal artery stenosis include:

  • Old age,

  • Hypertension,

  • Diabetes,

  • Coronary artery disease,

  • Peripheral artery disease,

  • Chronic kidney disease,

  • Tobacco consumption,

  • Abnormal cholesterol levels.

Symptoms

Renal artery stenosis generally does not show any specific symptoms. Oftentimes, the first sign of renal artery stenosis is high blood pressure. However, there are some signs and symptoms that can be diagnosed by a medical practitioner or a nephrologist which are given as follows:

  • Unmanageable high blood pressure,

  • Whooshing sound during blood flow which can be heard when the doctor listens through a stethoscope,

  • Elevated levels of protein in the urine or other signs of abnormal kidney function,

  • Worsening kidney function when treating high blood pressure problems,

  • Fluid accumulation and swelling in the tissues of the body,

  • Treatment-resistant heart failure.

Diagnosis

CARE Hospitals offer comprehensive diagnosis to patients provided by well-experienced nephrologists following international standards of protocols. If they suspect that a patient has renal artery stenosis, they may order tests to confirm the suspicion or to rule it out. Some of the diagnosis procedures include:

  • Blood and urine tests to evaluate the functioning of the kidney,

  • Kidney ultrasound uses sound waves to provide imaging of the size and structure of the kidneys,

  • Doppler ultrasound to measure blood flow speed in the renal arteries,

  • Magnetic resonance arteriogram and computed tomography angiography to perform imaging studies using a special contrast dye to produce a three-dimensional image of the kidney and its blood vessels,

  • Computed tomography angiogram to obtain detailed images of the heart and the blood vessels carrying blood to the heart, lungs, brains, kidneys, neck, legs, and arms. 

Treatments

Medication is often the first step of treatment which is administered by our multidisciplinary team of nephrologists and general medicine specialists. The condition may require three or more drugs to manage high blood pressure. These drugs may include cholesterol-lowering drugs and aspirin. 

In some cases, an intervention such as angioplasty including stenting or surgery may be recommended as a part of the surgery. During angioplasty, a catheter is inserted into the body via a blood vessel which is guided to the blocked or narrowed artery. A balloon attached to the catheter then inflates by opening up the inside of the artery. A stent can then be placed to keep the area open. 

Renal artery bypass surgery may be performed to bypass the narrowed or blocked portion of the artery. Sometimes removal of a non-functional kidney may be needed for some patients. 

Complications

There can be some complications arising from renal artery stenosis which include:

  • Persistent high blood pressure,

  • Kidney failure which requires kidney dialysis or in extreme cases a kidney transplant,

  • Fluid retention in the legs which causes swelling of the ankles and feet,

  • Sudden buildup of fluid in the lungs causes shortness of breath.

Recovery and postoperative care

At CARE Hospitals, our specialists provide comprehensive end-to-end support after treatment for renal artery stenosis. Our nephrologists may continue to monitor closely for atherosclerosis which is one of the main causes of this condition. During these follow-up sessions, check-ups may include routine blood tests and regular ultrasound testing. Lifestyle changes may also be recommended to help prevent atherosclerosis and keep the blood pressure in check. 

Our board-certified dieticians and nutritionists can design a diet to help lower blood pressure, improve cholesterol levels, reach and maintain a healthy weight as well as manage diabetes to help prevent a recurrence of renal artery stenosis. 

If a patient undergoes surgery for renal artery stenosis, he may require a hospital stay to recover fully. Patients will be closely monitored by doctors and help them to recover faster and treat any complications that may arise thereafter.

Frequently Asked Questions

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