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Alternative names Return to top
Renal artery occlusion; Stenosis - renal artery; Occlusion - renal artery; Fibromuscular dysplasia (FMD)Definition Return to top
Renal artery stenosis is a narrowing or blockage of the artery that supplies the kidney, caused by atherosclerosis, fibromuscular dysplasia of the renal artery wall, or scar formation in the artery. (See also atheroembolic renal disease.)Causes, incidence, and risk factors Return to top
Renal artery stenosis is caused when atheroembolic renal disease results in narrowing of the renal artery. Fibromuscular disease, a condition more common in young women in which fibrous tissue grows in the wall of the renal artery and narrows it, is a second cause. It may also be caused when scar tissue forms in the renal artery after acute arterial obstruction or traumatic injury to the kidney.
Renal artery stenosis often causes hypertension with no other signs of its presence, and it is usually discovered in investigation for the cause of hypertension that is difficult to control. Renal artery stenosis is, in fact, among the most common causes of secondary hypertension. The disorder may also be discovered when a bruit (loud whooshing sound) over the kidney is noted on examination with a stethoscope (auscultation).
In the elderly, renal artery stenosis is most commonly associated with atherosclerotic disorders, including atherosclerotic heart disease. Atherosclerotic plaque deposits within the renal artery and causes it to become stenosed (narrowed).
Fibromuscular dysplasia is a congenital disorder involving thickening of the arterial wall and is a cause of renal artery stenosis in younger adults, particularly women 20 to 40 years old.
Renal artery stenosis may cause chronic renal failure if it affects both renal arteries or if the hypertension associated with this condition is prolonged or severe.
Symptoms Return to top
There are usually no symptoms.Signs and tests Return to top
The blood pressure may be high, and there may be a history of hypertension that is refractory or difficult to control. A bruit may be heard on examination with a stethoscope (auscultation) over the kidney.Treatment Return to top
The treatment varies depending on the extent and severity of the symptoms. If the stenosis results in failure of a kidney, the second kidney may take over filtering and urine production for the body. Surgical repair of the stenosed area may be possible.
A balloon angioplasty (a radiographic procedure during which a balloon-tipped catheter is threaded through the artery) or a stent placement across the stenosis may be an alternative to surgery to open the stenosed area.
Antihypertensive medications may be needed to control high blood pressure.
Expectations (prognosis) Return to top
Renal artery stenosis may cause eventual failure of the kidney if it progressively blocks the artery. This may result in chronic renal failure if there is only one functional kidney or if both renal arteries are affected.Complications Return to top
Calling your health care provider Return to top
If your history indicates a high risk for renal artery stenosis, make an appointment to see your health care provider. However, decreased urine volume may be an emergency symptom indicating renal failure.Prevention Return to top
Renal artery stenosis may be prevented by avoiding smoking. Update Date: 1/19/2004 Updated by: Irfan A. Agha, M.D., Department of Medicine, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |