Renal Artery Stenosis (RAS) is a condition where the arteries that supply blood to the kidneys narrows. These arteries are critical for carrying the oxygen-rich blood to your kidneys, allowing for the efficient discard of waste and excess fluid. Renal disease can worsen over time leading to hypertension (high blood pressure) and kidney damage, and in worst case scenario, ultimately kidney failure.
Primarily the cause for RAS is due to the hardening of the arteries, where the arteries become clogged with a plaque made up of fat and cholesterol that cannot exit the body. In rare cases, a condition known as fibromuscular dysplasia can be the cause. In this case, the cells in the walls of the arteries grow abnormally. This condition is more prevalent in women and younger people with hypertension and is potentially curable if treated early.
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Blood pressure that is not controlled with medication
Decrease in kidney function
Retention of fluid
Edema (swelling) in the ankles and feet
Abnormal kidney function
Increased level of protein in your urine
Renal Artery Stenosis Diagnosis
Your medical provider will ask you questions pertaining to your history and perform a physical exam. The answers you provide will allow them to confirm or rule out disease.
Blood and urine test to evaluate kidney function
An ultrasound of the kidney
Doppler ultrasound of the arteries to determine flow
An arteriogram with contrast which provides detailed images of the kidney and vessels
Medical management of hypertension or kidney dysfunction is the first recommended treatment protocol in patients with RAS. In addition to anti-hypertensive medications, medical providers may also suggest that the patient take a cholesterol medication and aspirin daily.
In some cases, an intervention is needed. The typical procedure would be an angioplasty and stent of the stenosis. This can be done in an outpatient facility, with a minimally invasive technique, using fluoroscopy to place the stent and open the artery to improve kidney function. Finally, a surgical bypass can be performed, but is not common. The surgery will bypass the narrowed or blocked artery to restore proper flow.
Renal Artery Stenosis Prevention
Sometimes the best means of prevention are the most obvious. Choosing to live a heart-healthy lifestyle, including exercise, and elimination of risk factors can be your best defense against RAS.
The progression of RAS can lead to severe kidney damage with symptoms including change in urine output, edema, fatigue, muscle cramps, nausea, and sudden weight loss. If you are experiencing these changes, see your doctor and be evaluated.
The main cause of RAS is atherosclerosis – the process in which plaque and cholesterol build up on the inside walls of the blood vessels, causing issues with the blood flow to the kidneys.
Risk factors include age, being female, high blood pressure, presence of vascular disease, patients with chronic kidney issues, diabetics, smokers, and high cholesterol.
The best way to reduce your chances of developing RAS is to adopt heart-healthy lifestyle choices and modify the risk factors you are able to control. Communicate with your doctor, and be mindful of your body and what your body is trying to tell you.
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