Renal artery stenosis occurs when plaque builds up in one or more of the arteries carrying blood to your kidneys. This condition can cause reduced blood flow to your kidneys, which can damage them over time and raise your overall blood pressure. Severe renal artery stenosis or a complete renal artery blockage (total occlusion) can require emergency surgery.
What causes renal artery stenosis?
There are two main causes:
- Atherosclerosis: With this condition, the arteries in your body harden and narrow, and plaque can build up, eventually causing blood clots. This disease often leads to heart disease and other issues because of reduced blood flow to the heart and other key organs, including the kidneys. Atherosclerosis is caused by genetics and lifestyle factors, such as poor diet, limited exercise and smoking.
- Fibromuscular dysplasia: This rare condition is a congenital disorder, meaning that you’ve had it since birth. The arteries develop in infancy and beyond with alternating narrower and wider areas, like beads on a necklace, causing issues with blood flow.
What are the symptoms of renal artery stenosis?
Renal artery stenosis can be difficult to diagnose and may remain asymptomatic until it’s severe. The most common symptoms of renal artery stenosis are:
- Unusual issues with blood pressure, including:
- Blood pressure that is difficult to control through medication or lifestyle changes
- High blood pressure before age 30
- High blood pressure that occurs suddenly in a person over age 50
- High blood pressure that worsens suddenly, with no explanation
- An abnormal kidney reading from a routine blood or urine test
- Edema, which means swelling and seeping from the body’s tissues, particularly the feet or legs
- Shortness of breath, fatigue or muscle weakness and cramps
- Unusually frequent or infrequent urination
What are the risk factors for renal artery stenosis?
Because renal artery stenosis is most often caused by atherosclerosis (the narrowing and hardening of the body’s arteries), its risk factors are the same as for coronary artery disease. The best way to avoid it is through a heart-healthy lifestyle. Risk factors include:
- Smoking
- Family history of heart disease and atherosclerosis
- Having high blood pressure or high cholesterol
- Advanced age
- Uncontrolled diabetes
What are the complications of renal artery stenosis?
Because renal artery stenosis results in reduced or blocked blood flow to your kidneys, it can cause permanent kidney damage. This can lead to chronic kidney disease, kidney atrophy or renal hypertension, and—in the long run—kidney failure.
The kidneys also play a key role in regulating blood pressure. As blood filters through the kidneys, your kidneys remove water, salt and other impurities. In turn, they also produce important hormones that keep your blood pressure regulated. When the kidneys are damaged, your blood pressure may rise, leading to artery damage in other areas, such as your heart or far extremities.
Treatment for Renal Artery Stenosis
Making modifications to your lifestyle can improve renal artery stenosis and head off long-term complications. These lifestyle changes also may have an impact on your recovery after a procedure to treat renal artery stenosis, if you need one. Generally, patients with renal artery stenosis should follow a heart-healthy lifestyle by:
- Quitting smoking.
- Getting more exercise.
- Eating more fruits, vegetables and whole grains, while limiting the intake of high-fat foods and salt.
- Managing your stress.
- If you have diabetes, controlling your blood glucose and lowering your A1C.
Medications for renal artery stenosis primarily treat the underlying causes of narrowed, hardened arteries (atherosclerosis) and prevent significant complications, such as blood clots or complete blockages (total occlusions). Your vascular surgeon may prescribe:
- Statins, a type of medication used to lower high cholesterol.
- Beta blockers, a type of medication used to lower high blood pressure by lowering your heart rate.
- ACE inhibitors, a type of medication that relaxes the veins and arteries to lower blood pressure.
- Aspirin or blood thinners, which can help prevent blood clots.
- Diuretics, which can reduce edema, the collection of fluid and swelling in the body, most often in the legs or feet.
These procedures, performed in our state-of-the-art endovascular suite, give patients a high-quality alternative to open surgery to treat narrowed renal arteries.
- Balloon angioplasty: Through a small incision made in the groin, your vascular surgeon will direct a catheter into an artery and thread it up to the occluded renal artery. From there, a tiny balloon will be used to widen the artery.
- Stenting: During this same procedure, a permanent structure called a stent may be placed into the artery to keep it open so that the blood can pass through to the kidneys.
Occasionally, surgery may be required instead of a minimally invasive procedure. When that happens, our Vascular Center has experience in performing these critical surgeries.
- Renal artery bypass surgery: In an artery bypass surgery, a vascular surgeon will create an alternative pathway for blood to flow around the blockage in your artery. Typically, this is done either by placing a synthetic tube or by harvesting a vein from another part of your body. From there, the surgeon will attach the new vein above and below the blockage in your artery, allowing the blood to effectively “bypass” the clot.
- Renal artery endarterectomy: Endarterectomy is a type of arterial surgery where a vascular surgeon opens up the blocked or narrowed artery and removes the built-up plaque.
Both surgeries are performed under general anesthesia, and patients should expect a hospital stay after.
Why choose Georgia Heart Institute?
Through the expertise of our partners from the Vascular Center of Northeast Georgia Physicians Group and the advanced technology available at Northeast Georgia Medical Center, Georgia Heart Institute offers leading vascular care for patients across the region.
Our vascular surgeons develop long-term relationships with our patients to ensure they have not only a successful procedure but also a successful recovery. Whether you need preventive care, disease management, a minimally invasive procedure or surgery, or rehabilitation, we’re here at every step of your journey.
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