Renal Artery Stenosis

What is renal artery stenosis?

Renal artery stenosis is when one or more of the arteries responsible for carrying blood to your kidneys narrow. The blood flow helps your body remove excess fluids and filter waste. If your arteries narrow, you may experience damaged kidney tissue. Renal artery stenosis can also increase your body’s blood pressure.

What are symptoms of renal artery stenosis?

You will not necessarily notice symptoms of renal artery stenosis until it progresses to an advanced stage. Doctors will sometimes unintentionally discover the condition when running tests for something else. Symptoms that can alert your doctor may include:

• An unexplained development or worsening of high blood pressure
• The development of high blood pressure before age 30 or after age 50

Other potential indicators and symptoms of advanced renal artery stenosis are:

• Hard-to-control high blood pressure
• A whooshing sound of blood flowing through a thin vessel
• Higher protein levels in the urine or other abnormal kidney functions
• Overwhelming amounts of fluid
• Swelling in the body’s tissues
• Worsening kidney function while the doctor treats your high blood pressure
• Your body resisting treatment for heart failure

These symptoms are not necessarily related to renal artery stenosis. Make an appointment and speak with a physician if you notice an overlap or have any questions.

What causes renal artery stenosis?

There are two primary causes of renal artery stenosis. They are:

• Build-up on the kidney (renal) arteries. Fats and cholesterols can accumulate as plaque on your kidney artery walls. When the deposits grow, they also harden. The plaque limits blood flow, results in kidney scarring, and will narrow your arteries.
• Fibromuscular dysplasia. Oftentimes from childhood, the artery wall muscle will grow in an abnormal way. If the arteries are too narrow, the kidneys cannot receive enough blood to properly function and sustain themselves. It can lead to individuals developing high blood pressure, even at a young age. Women are more prone to developing renal artery stenosis from fibromuscular dysplasia.

These causes can lead to complications in other arteries throughout your body. Consult with a medical professional if you have any knowledge of a related family history.

How is renal artery stenosis diagnosed?

A doctor can run through several diagnostic tests for renal artery stenosis. The preliminary methods of diagnosing the condition include:

• A physical exam – The doctor will listen over the kidney areas using a stethoscope. The test can reveal sounds that may indicate that your renal artery has narrowed.
• Reviewing medical history – Past family histories of heart disease may indicate an increased likelihood of renal artery stenosis.
• Blood and urine tests – Doctors will use the tests to check your kidney function. They can also use the tests to measure your hormone levels that regulate blood pressure.

You can also speak with a doctor about undergoing imaging tests. The most common imaging tests for diagnosing renal artery stenosis are:

• CT scan – Your doctor can gain a clearer, detailed picture of your renal arteries.
• Doppler ultrasound – The high-frequency sound waves show the arteries and kidney function. They also reveal blockages within the blood vessels. Your doctor can further measure their severity to determine treatment options.
• Magnetic resonance angiography – MRA presents 3D images of the kidneys and renal arteries.

• Renal arteriography – Doctors use the X-ray exam to identify any blockages in the renal arteries. Speak with your doctor to see if the test is necessary for you. A doctor may elect to do the exam if they need to insert a stent to widen your blood vessel.

Are there any risk factors or groups for renal artery stenosis?

Narrowing kidney arteries most commonly cause renal artery stenosis. There are certain risk factors that cause your arteries to become narrower throughout your body. They may include:

• Aging
• High blood pressure
• Diabetes
• High cholesterol
• Obesity
• Genetic heart disease
• Smoking and/or additional tobacco usage
• Lack of physical activity

Are there any complications associated with renal artery stenosis?

Multiple complications, aside from high blood pressure, can arise from renal artery stenosis. You may notice the following complications:

• Kidney failure – You will need to seek dialysis treatment or pursue a kidney transplant.

• Fluid retention – Your ankles or feet may swell as your legs retain fluid.
• Shortness of breath – Fluid will build up in the lungs, resulting in difficulty breathing.

Speaking with a medical professional when you start noticing symptoms may minimize future complications associated with renal artery stenosis.

How is renal artery stenosis treated?

Medical professionals may recommend several different ways of treating renal artery stenosis. Some treatment methods involve lifestyle changes, medication, and working to restore blood flow to your kidneys. Some doctors may suggest combining treatment methods for optimal results. Treatment, or lack thereof, will depend on your symptoms and general health.

Medications for treating renal artery stenosis often target high blood pressure. It may take some trial and error for your doctor to find the right medication or combination of medications to treat your condition. The common medications for treating high blood pressure as it relates to renal artery stenosis are:

• ACE inhibitors and angiotensin II receptor blockers (ARBs) – ACE inhibitors and ARBs relax your blood vessels.
• Diuretics – Water pills can help release excess water and sodium from your body.
• Beta blockers and alpha-beta blockers – The blockers can make your heart beat less forcefully or widen the body’s blood vessels.
• Calcium channel blockers – These types of blockers also help to relax the body’s blood vessels.

Doctors may also recommend certain medical procedures as another form of treatment for renal artery stenosis. Common procedures for the condition include renal angioplasty and stenting, as well as renal artery bypass surgery.

• Renal angioplasty and stenting – Widening the artery and inserting the stent allow for better blood flow through the blood vessel.
• Renal artery bypass surgery – Doctors design a new route for blood to flow to your kidneys. Medical professionals typically perform the procedure when angioplasty is unsuccessful. Doctors may also do renal artery bypass surgery as an additional procedure.

Discuss your medical options with your healthcare provider before trying to make any plans. Treatment options are not one-size-fits-all and may be adjusted to better suit your needs.

What are lifestyle changes that could help prevent renal artery stenosis?

If your condition is not severe, your doctor may recommend lifestyle changes as your treatment plan. Certain changes you can adapt into your daily life are:

• Maintaining a healthy weight. Your blood pressure will fluctuate with your weight. Losing weight can help regulate blood pressure and prevent hypertension.

• Limiting your salt intake. Salt leads to your body retaining fluid. When you retain fluid, it may raise your blood’s volume, which can increase blood pressure.
• Becoming more physically active. Ask your doctor about the appropriate exercise regimen. Changing your activity too abruptly can lead to further complications based solely on your overall health and age.
• Reducing stress. Higher stress levels can lead to higher blood pressure.
• Minimizing or eliminating alcohol. Excess alcohol may raise your blood pressure.
• Quitting smoking. Tobacco products can harden your arteries at a quicker rate. Speak with your doctor about the steps you should take to stop smoking.

Should you see a doctor about renal artery stenosis?

You should make a doctor’s appointment about possible renal artery stenosis if you notice any concerning signs or symptoms. Once you speak with a general practitioner, they may refer you to a nephrologist or a cardiologist. There are a number of ways that you can prepare ahead of time for a consultation with a specialist.

• Keep track of your symptoms. Any symptoms are important to note, even those that seem unrelated. They will provide greater insight for any specialist that examines you.
• Make a list of current vitamins, supplements, and medications. You should also make a note of each one’s dosage.
• Provide all relevant information. Inform your doctor if you have a family history of heart or kidney disease. Similarly, disclose any past or present smoking and tobacco tendencies.

• Bring along a friend or family member. If you have difficulty remembering certain details, it can help to bring along a knowledgeable third party.

• Prepare some questions. When you meet with your doctor, come with questions.

What is the outlook for people living with renal artery stenosis?

The outlook for renal artery stenosis depends on how quickly medical professionals detect it and begin treatment for the condition. If you notice worrying symptoms, speak immediately with your doctor for a better outcome. Identifiers that may mean the kidney disease is progressing are:

• Darkened skin
• Differences in urine output
• Edema, or swelling, that spreads across the body and reaches your face
• Increased fatigue
• Nausea or vomiting
• Muscle cramps
• Unintentional and abrupt weight loss

Renal artery stenosis can result in permanent damage to your kidneys if you do not seek any treatment. It is also crucial to speak with a medical provider if you have underlying conditions like high blood pressure. Ignoring the damaged kidney tissues can lead to kidney failure and potentially require a kidney transplant.