Renal Vascular Disease

Renal vascular disease refers to a number of causes that reduce blood flow through veins and arteries of the kidneys. Without proper treatment, renal vascular disease can lead to high blood pressure and kidney failure. Spectrum Health’s vascular specialists collaborate with a multidisciplinary team to provide the best expertise and comprehensive treatment plan for each patient.

Treatments for Renal Vascular Disease

Treating renal vascular disease focuses on taking pressure off the veins that carry blood to your kidneys. We start with medicine that eases blood flow through congested veins and arteries.

If you need additional help, our experts will talk to you about next steps. We don't need to remind you how important it is to protect your blood pressure and your kidneys for the future.

Percutaneous Coronary Intervention (Angioplasty/Stent Placement)
An angioplasty is a less invasive procedure that opens a clogged artery with a small balloon. This can be done through the wrist (radial) or the groin (femoral) artery. Typically this procedure includes the placement of stents.

Bypass Surgery
This surgery creates a bypass graft using a healthy blood vessel from another part of the body or a synthetic tube to reroute blood flow.

Stent Placement
A small mesh tube is surgically placed in the blood vessel or artery to keep it open for blood flow. Some stents are embedded with drugs to offer further protection against clogging. Some heart conditions call for the use of bare metal stents.

What Is Renal Artery Stenosis?

Each kidney gets blood through an artery that comes from the aorta, the major blood vessel from the heart. Renal artery stenosis (RAS) is the narrowing or complete blocking of arteries bringing blood to the kidneys. Narrow arteries can lead to high blood pressure (hypertension). When both arteries are blocked, serious problems, including kidney failure, can result. One or both kidneys can be blocked.

What Causes Renal Artery Stenosis?

In older people, the usual cause is atherosclerosis (hardening of the arteries). In atherosclerosis, fat, cholesterol, and other substances collect in artery walls. In younger adults, a condition known as fibromuscular dysplasia is the most common cause. In this illness, tissue grows in walls of renal arteries and narrows or blocks them.

What Are the Symptoms of Renal Artery Stenosis?

People usually have no symptoms. They don’t know that they have it until they begin to have high blood pressure or kidney failure.

How Is Renal Artery Stenosis Diagnosed?

The health care provider makes a diagnosis from a medical history and physical examination. Blood and urine tests and magnetic resonance angiography (MRA) of renal arteries may be done. MRA is a special x-ray of blood vessels bringing blood to kidneys.

How Is Renal Artery Stenosis Treated?

Treatment depends on the severity and cause of the stenosis and personal preference. Mild or moderate symptoms can sometimes be treated with medicine to control high blood pressure. A more severe condition may need the artery to be widened or reopened by surgery.

A treatment called angioplasty may be used instead of surgery. This treatment is more frequently performed when the cause is fibromuscular dysplasia but not atherosclerosis. A plastic balloon is used to open the narrowed artery. A metal or mesh tube called a stent may be put in to keep the artery open. The procedure may have to be repeated because narrowing may return. High blood pressure medicine may still be needed.

DOs and DON’Ts in Managing Renal Artery Stenosis:
  • DO take your medicine regularly and as directed. This is the most important thing you can do to delay or prevent worsening of kidney function.
  • DO exercise regularly. Exercise will reduce the risk of complications, such as heart disease, caused by high blood pressure.
  • DO eat healthy food. Follow your dietitian’s advice to lower your blood cholesterol levels. High levels increase the risk of heart disease. A low-salt diet also helps lower blood pressure.
  • DO call your health care provider if your blood pressure stays high.
  • DO call your health care provider if you have side effects from medicines.
  • DO make regular appointments with your health care provider to check your kidneys and blood pressure.
  • DON’T smoke. Smoking can damage your arteries.
  • DON’T miss appointments to have your blood pressure checked. Do this at least every 6 months.
  • DON’T stop taking your medicine without asking your health care provider.
  • DON’T take over-the-counter drugs, especially drugs similar to ibuprofen, unless your health care provider says you can. Some may not be safe to take with your kidney condition and may make it worse.
  • DON’T take herbal preparations. Some may cause kidney disease.

Contact the following sources:

  • National Kidney Foundation
    Tel: (800) 622-9010
  • National Kidney and Urologic Diseases
    Information Clearinghouse
    Tel: (800) 891-5390

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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