Renal Artery Stenosis
What is Renal Artery Stenosis?
Renal artery stenosis is a narrowing of one or both arteries that carry blood to your kidneys. When these arteries get narrow, less blood reaches your kidneys. Your kidneys need steady blood flow to filter waste and balance fluids in your body.
The narrowing usually happens from plaque buildup inside the artery walls. This is the same process that causes heart disease. In younger people, a condition called fibromuscular dysplasia can cause the artery walls to grow abnormally. Either way, your kidneys respond to reduced blood flow by releasing hormones that raise your blood pressure.
Many people with renal artery stenosis develop high blood pressure that is hard to control with medication. Over time, reduced blood flow can damage kidney function. Catching this condition early helps protect both your kidneys and your heart.
Symptoms
- High blood pressure that starts suddenly or worsens quickly
- High blood pressure that does not respond to three or more medications
- High blood pressure that starts before age 30 or after age 50
- A whooshing sound heard over the abdomen during a physical exam
- Decreased kidney function that starts after taking certain blood pressure medications
- Fluid buildup in the lungs that happens suddenly
- Unexplained decline in kidney function
- Swelling in the ankles or legs
- Fatigue and decreased energy
Many people have no symptoms in the early stages. The condition is often discovered when doctors investigate hard to control high blood pressure or unexpected changes in kidney function.
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Causes and risk factors
The most common cause of renal artery stenosis is atherosclerosis, which is plaque buildup in the artery walls. This affects about 90% of people with the condition. Risk factors include smoking, high cholesterol, diabetes, older age, and family history of heart disease. The same lifestyle factors that lead to heart disease also damage the arteries feeding your kidneys.
Fibromuscular dysplasia causes the other 10% of cases. This condition makes artery walls grow abnormally thick or develop unusual patterns. It happens more often in women and people under age 50. High blood pressure, chronic inflammation, and obesity increase your risk. Rarely, conditions like Takayasu arteritis or blood clots can narrow the renal arteries.
How it's diagnosed
Doctors diagnose renal artery stenosis through imaging tests that show narrowed arteries. A duplex ultrasound uses sound waves to measure blood flow through the renal arteries. CT angiography and magnetic resonance angiography create detailed pictures of the blood vessels. The most accurate test is renal arteriography, where dye is injected into the arteries during an X-ray procedure.
Blood tests help identify how the condition affects your kidney function. Rite Aid's blood testing panel measures key biomarkers including eGFR, which shows how well your kidneys filter waste. Cystatin C gives an accurate picture of kidney function when blood flow is reduced. Plasma renin activity reveals if your kidneys are releasing excess hormones in response to decreased blood flow. These markers help your doctor understand the impact on your kidneys and guide treatment decisions. Testing is available at Quest Diagnostics locations nationwide.
Treatment options
- Blood pressure medications including ACE inhibitors, ARBs, calcium channel blockers, and diuretics
- Statin medications to lower cholesterol and stabilize plaque
- Antiplatelet drugs like aspirin to prevent blood clots
- Angioplasty with stenting to open narrowed arteries in severe cases
- Surgical bypass of the blocked artery in rare cases
- Quitting smoking to prevent further artery damage
- Following a low sodium diet to help control blood pressure
- Regular exercise to support heart and kidney health
- Maintaining healthy blood sugar levels if you have diabetes
- Regular monitoring of kidney function and blood pressure
Concerned about Renal Artery Stenosis? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
The main symptom is high blood pressure that starts suddenly or becomes difficult to control with medications. Many people need three or more blood pressure drugs without success. Some people develop high blood pressure before age 30 or after age 50, which is unusual. Others have no symptoms until kidney damage occurs.
Blood tests cannot directly see the narrowed artery, but they show how the condition affects your kidneys. Tests like eGFR and cystatin C measure kidney filtering function, which declines when arteries are blocked. Plasma renin activity shows if your kidneys are releasing excess hormones due to reduced blood flow. These markers help doctors identify the condition and track kidney health over time.
Renal artery stenosis is a specific cause of kidney disease, not kidney disease itself. The narrowed arteries reduce blood flow to the kidneys. Over time, this can lead to chronic kidney disease if left untreated. Treating the stenosis early can prevent permanent kidney damage.
Untreated stenosis can lead to permanently reduced kidney function or kidney failure. High blood pressure may worsen and damage your heart, brain, and blood vessels. You may develop fluid buildup in your lungs or experience sudden heart problems. Early detection and treatment protect your kidneys and prevent these serious outcomes.
People over 50 with atherosclerosis risk factors face the highest risk. This includes smokers, people with high cholesterol, diabetes, and family history of heart disease. Women under 50 are more likely to develop fibromuscular dysplasia, another cause of the condition. Anyone with hard to control high blood pressure should be evaluated.
Treatment starts with medications to control blood pressure and protect kidney function. Lifestyle changes like quitting smoking, eating less salt, and exercising regularly are essential. In severe cases, doctors may use angioplasty to open the narrowed artery with a balloon and stent. Surgery is rarely needed when other treatments fail.
Lifestyle changes cannot reverse existing narrowing, but they can prevent the condition from worsening. Quitting smoking stops further artery damage. A heart healthy diet and regular exercise improve blood pressure and cholesterol levels. These changes reduce stress on your kidneys and lower the risk of complications.
Most people need blood tests every 3 to 6 months to monitor kidney function and treatment response. Your doctor will track eGFR and cystatin C to watch for changes in kidney filtering ability. Blood pressure should be checked regularly at home and during medical visits. More frequent testing may be needed if your condition worsens or treatment changes.
ACE inhibitors and ARBs can sometimes worsen kidney function in people with severe bilateral stenosis or stenosis in a single functioning kidney. Your doctor will monitor your kidney function closely if you take these medications. Nonsteroidal anti-inflammatory drugs like ibuprofen can also stress the kidneys. Always discuss new medications with your doctor before starting them.
Yes, severe or untreated stenosis can lead to kidney failure over time. When one or both kidneys receive too little blood for too long, the tissue can become permanently damaged. Regular monitoring with blood tests helps catch declining function early. Treatment can slow or stop progression to kidney failure in most cases.