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|The Kidney and Its Main Blood Vessels|
|Copyright © Nucleus Medical Media, Inc.|
- Atherosclerosis—often called “hardening of the arteries,” results when fatty plaque builds up in the arteries and blocks blood flow to the kidneys. This occurs mainly in men over 50.
- Fibromuscular dysplasia—an inherited disorder where muscle and fibrous tissue of the renal artery wall thicken and harden into rings that block blood flow to the kidneys. This occurs mainly in young females in their 30s.
- Very high and difficult to control blood pressure
- A “whooshing” sound in the abdomen, heard with a stethoscope
- Episodes of heart failure
- Rapid kidney failure
- Newly discovered hypertension in men over 50 years old or young women in their 30s
- Renal arteriography—a dye is injected into the kidney arteries and an x-ray is then taken of them
- Doppler ultrasound —a procedure that uses sound waves to examine various parts of the body
- Magnetic resonance angiography —a procedure that produces very detailed two- and three-dimensional images of the arteries by using radio waves in a strong magnetic field instead of using x-rays
- Angiotensin-converting enzyme (ACE) inhibition renography—a noninvasive imaging procedure that tests for the presence of renovascular hypertension and renal artery stenosis
- CT angiography—a procedure that uses high resolution CT scan images and contrast injected into a vein to give an accurate picture of the renal arteries. This procedure is rapidly replacing renal arteriography.
- Calcium channel blockers
- ACE inhibitors (except in those with both renal arteries blocked)
- Angiotensin receptor blockers
Interventions to Correct Renovascular Hypertension
- Revascularization—A vascular surgeon will perform a major operation, which creates a new path for blood flow to the kidneys by connecting one of your veins, or a tube, above and below the blocked area.
- Angioplasty —This is a less invasive method in which a catheter with a balloon at its tip is inserted into the blocked artery. The balloon is quickly inflated and deflated to stretch open the artery to allow blood flow. Your physician may insert a small metal mesh tube, called a stent, into the artery to help it stay open.
- Endarterectomy —This is another type of major surgery in which there is removal of the inner-lining of the renal artery containing the plaque.
- Stop smoking.
- Maintain a healthy weight.
- Maintain healthy cholesterol and lipid levels.
- Exercise regularly.
- Eat a low-fat, low-protein, low-sodium, high-fiber diet.
Society for Vascular Surgery http://www.vascularweb.org/
Canadian Cardiovascular Society http://www.ccs.ca/home/index%5Fe.aspx
Venous Disease Coalition http://www.venousdiseasecoalition.org/
DynaMed Editorial Team. Renal artery stenosis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated November 4, 2010. Accessed November 11, 2010.
Fenves AZ, Ram CV. Renovascular hypertension: clinical concepts. Minerva Med. 2006;97:313-324.
Mayo Clinic. Secondary high blood pressure: hypertension resulting from another condition. MayoClinic website. Available at http://www.mayoclinic.com/health/secondary-hypertension/DS01114 . Accessed January 13, 2008.
Patient UK. Renal vascular disease. Patient UK website. Available at http://www.patient.co.uk/doctor/Renal-Vascular-Disease.htm . Updated October 30, 2008. Accessed November 11, 2010.
Society for Vascular Surgery. Renovascular conditions. Society for Vascular Surgery website. Available at http://www.vascularweb.org/vascularhealth/Pages/renovascular-conditions.aspx . Accessed January 13, 2008.
- Reviewer: Michael J. Fucci, DO
- Review Date: 09/2012
- Update Date: 05/11/2013