The Truth About 4 Popular Heart Health Supplements
Renal Artery Stenosis
Renal artery stenosis is a narrowing of arteries that carry blood to one or both of 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 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 lead to an increase in blood pressure. Over time, renal artery stenosis can lead to kidney failure.
More than 90% of the time, renal artery stenosis is caused by atherosclerosis, a process in which plaque made up of fats, cholesterol, and other materials builds up on the walls of the blood vessels, including those leading to the kidneys.
More rarely, renal artery stenosis can be caused by a condition called fibromuscular dysplasia, in which the cells in the walls of the arteries undergo abnormal growth. More commonly seen in women and younger people, fibromuscular dysplasia is potentially curable.
Renal artery stenosis is often found by accident in patients who are undergoing tests for another reason. Risk factors include:
Renal artery stenosis usually does not cause any specific symptoms. Sometimes, the first sign of renal artery stenosis is high blood pressure that is extremely hard to control, along with worsening of previously well-controlled high blood pressure, or elevated blood pressure that affects other organs in the body.
If your doctor suspects that you have renal artery stenosis, they may order tests to either confirm suspicions or rule it out. These include:
Initial treatment for renal artery stenosis is often medication. The condition may require three or more different drugs to control high blood pressure. Patients may also be asked to take other medications, such as cholesterol-lowering drugs and aspirin.
For a small number of people, an intervention such as angioplasty, often with stenting or surgery, may be recommended. With angioplasty, a catheter is inserted into the body through a blood vessel and guided to the narrowed or blocked renal artery. A balloon on the catheter is then inflated to open up the inside of the artery. A stent can then be placed to keep the area open.
Surgery to bypass the narrowed or blocked portion of the artery and/or remove a non-functioning kidney may be needed for some patients. But this procedure is not often done.
If you're diagnosed with renal artery stenosis, it's important to discuss the risks of the different treatments with your doctor. The side effects of blood pressure medications may include dizziness, sexual problems, headache, and cough. Complications of angioplasty include bruising, bleeding, additional kidney damage, and the possibility that the arteries can close again.
Diagnosis And Treatment Of Renal Artery Stenosis
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Frequency Of Renal Artery Stenosis And Variants Of Renal Vascularization In Hypertensive Patients: Analysis Of 1550 Angiographies In One Centre
Renal artery stenosis (RAS) is an important cause of arterial hypertension and chronic kidney disease. The aims of our study were to assess the prevalence of RAS and to examine the frequency of variants of renal vasculature, that is, multiple and/or accessory renal arteries in hypertensive patients referred to renal angiography. We evaluated retrospectively 1554 arteriographies of hypertensive patients. Angiograms were evaluated to find RAS, significant RAS (>60% stenosis of the lumen), radiological signs of atherosclerosis, aneurysms of the renal arteries or aorta and variants of kidney vascularization. The frequency of RAS including occlusions was 15.1% (21.3% of them were significant and suitable for revascularization). Variants of renal arterial vascularization were found in 26.5% of patients (multiple renal arteries—11.2% and accessory renal arteries—15.3%). Significant RAS was found more frequently in patients older than 60 years—OR 4.76 (2.08–10.86). Coronary artery disease, history of myocardial infarction or stroke significantly increased the chance of RAS detection. The frequency of renal accessory arteries was lower in patients older than 60 years and in patients with the radiological signs of atherosclerosis. Results of this study indicate that haemodynamically important RAS is found more frequently in hypertensive patients older than 60 years. Symptomatic atherosclerotic disease found in the peripheral and/or coronary arteries and diabetes mellitus increases the chance of RAS detection. Decreased occurrence of renal accessory arteries was found in hypertensive patients with radiological signs of atherosclerosis.
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