Definition:
Renal artery stenosis is a condition characterized by the narrowing of the renal artery, often as a result of atherosclerosis or fibromuscular dysplasia. The narrowing of the renal artery obstructs the blood flow to the target kidney, which leads to hypertension and atrophy of the affected kidney, which in turn causes renal artery stenosis, and ultimately to renal failure if untreated.
Diagnosis:
To diagnose renal artery stenosis, physicians may evaluate and compare levels of rennin, a hormone released by the kidneys which regulates blood pressure, within the right and left renal veins. If rennin levels in one side are distinctly higher than the other, this indicates a kidney that releases high amounts of rennin, a symptom consistent with renal artery stenosis.
Treatment:
Medication for renal artery stenosis is focused on managing high blood pressure in patients. However, in severe cases where hypertension cannot be controlled through medication, renal artery stenosis may have to be treated invasively. Renal artery stenosis is frequently treated through endovascular methods, such as angioplasty.
Symptoms and Signs:
Most patients suffering from renal artery stenosis are asymptomatic. The problem, however, is rooted in the resulting high blood pressure which usually cannot be managed through medication. Renal defects and gradual deterioration in renal function can potentially develop if both kidneys are poorly supplied. In some cases, renal artery stenosis manifests with attacks of sudden left ventricular heart failure (or flash pulmonary edema).
Causes:
The major cause of renal artery stenosis is atherosclerosis. Those with a sudden onset of hypertension at 50 years old or beyond usually develop renal artery stenosis. In young patients, usually in females under age 40, the leading cause is fibromuscular dysplasia.
Other causes for renal artery stenosis include arthritis, extrinsic compression, renal artery aneurysm, neurofibromatosis, and fibrous bands.
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