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Renal Artery Stenosis

Narrowing of one or both arteries of the kidney is a condition called renal artery stenosis (RAS). The most common cause of RAS is atherosclerosis, in which fatty materials are deposited along the arteries’ interior walls, restricting blood flow to the kidney. Lacking sufficient blood supply triggers the kidney to “think” that the body’s blood pressure is too low, and it secretes a hormone called Renin, which causes the body to retain salt and water, resulting in hypertension (high blood pressure).

Approximately 5% of people with high blood pressure can attribute their condition to RAS. And, left untreated, RAS can cause progressive kidney failure and pulmonary edema (fluid in the lungs).

Signs of Renal Artery Stenosis:

• Elevated blood pressure un-resolved with oral medications
• Sudden worsening of hypertension previously well-controlled
• Deterioration of kidney function

Diagnosis of RAS can be made using a combination of:

• Duplex ultrasound imaging
• Magnetic Resonance Angiography (MRA)
• Computed Tomographic (CT) Angiography
• Radionuclide Renal Scanning

Catheter Angiography Treatment:
Restoring normal blood flow to the kidneys may lower the blood pressure, preserve renal function and decrease the risk of pulmonary edema. Many lesions can be fixed using minimally invasive angioplasty and stent placement. Other narrowings require more invasive surgical reconstruction for optimal results.

Outcomes:
Following stenting, 30-60% of patients experience improved blood pressure control, often requiring fewer medications. Renal function is improved in a smaller percentage of patients.

The Advanced Endovascular Institute at Anaheim Memorial Medical Center specializes in noninvasive and angiographic diagnosis and treatment of RAS. If angioplasty stenting is not possible, surgical reconstruction can be performed by our highly experienced vascular surgeons. Ask your doctor if you should be evaluated for renal artery stenosis.