What is Renovascular Disease?

Symptoms

What are the Signs of a Problem?

Renovascular disorders cause high blood pressure, often extreme. Sometimes it's hard to tell if hypertension is from renal artery problems or something else.

Some signs of renovascular diseases are:

  • High blood pressure at an early age
  • Extremely high blood pressure that can't be controlled
  • Kidney dysfunction
  • Narrowing of arteries throughout the body
  • Signs of malignant hypertension (headaches, confusion, nausea, vision changes)

Diagnosis

How are Renovascular Diseases Diagnosed?

A general exam, with blood and urine tests, will show problems. Your health care provider may then order more studies. These diseases can be diagnosed with a group of tests that evaluate your overall kidney function and blood flow.

Imaging tests to see if your renal arteries have narrowed include:

  • A doppler ultrasound of the renal arteries
  • A renal angiogram to see a silhouette of the renal artery
  • A 3D CT renal angiogram to see the cause of renal artery stenosis; to see the extent of the disease; to see if the aorta is blocked

Treatment

What are Some Treatment Options?

Without treatment, renovascular disease can be deadly. Fortunately treatment is available. The goal of treatment is to control blood pressure and prevent kidney failure.

Lifestyle Changes

If you smoke, your health care team (and your loved ones) will suggest that you stop. You will also be asked to change your diet and do more exercises to improve your heart health. Maintaining healthy lifestyle habits have been proven to help.

Medicine

With lifestyle changes, treatment often starts with medicine to control blood pressure. It can also include aspirin, cholesterol-lowering drugs, and drugs for other conditions. High blood pressure pills are very good at controlling blood pressure, but the disease may go on to block arteries. Your medical team will aim to prevent the loss of kidney tissue and progressive kidney failure. This is more difficult if renal artery stenosis hurts both kidneys.

Surgical Procedures

If you need more treatment, your doctor may recommend surgery. Endovascular procedures are used to remove blocks in your kidney arteries. These treatments can restore blood flow to your kidneys. When blood flow returns, your kidneys can function and high blood pressure may lower.

Balloon angioplasty is a common treatment for blocks in the renal artery. It is done inside the blood vessel with a tiny balloon on the end of a small, flexible tube, called a catheter. It is important to find a doctor with special training for this. In atherosclerotic disease, a renal artery stent may also be done. Research has shown that this helps for a while, but more treatment may be needed over time.

Surgical revascularization (surgery to renew blood flow) may be needed. It is used when medicine, balloon angioplasty and stent placement don't help enough. This is also used when kidney failure is found. There are many surgical procedures available to renew blood flow. For example, aortorenal bypass grafts and extra anatomic bypass procedures.

If you need a more complex procedure called bench surgery. This includes a kidney transplant, with the reconstruction of the renal vessel.

After Treatment

What Can be Expected After Treatment?

After treatment, you can expect your blood pressure to improve. Also, your kidneys will begin to function better. Still, careful follow-up after treatment is important with this diagnosis.

The disease has been seen to come back after 3 years in about 15% of people with mural dysplasia after treatment. For AS-RAS, about 44% of people find that it’s still hard to control blood pressure or kidney failure after treatment.

More Information

More Information

Frequently asked questions

Can renovascular disease lead to kidney failure?

Yes. Signs of oncoming kidney failure are:

  • Puffy eyes, hands and feet
  • Loss of appetite
  • Nausea and vomiting
  • A bad taste in the mouth
  • Weight loss
  • General and ongoing itchy skin
  • Muscle twitching or cramping
  • A yellowish-brown tint to skin color

As kidney failure gets worse, and toxins build-up in the body, seizures and mental confusion can occur.

What are some complications of renovascular disease?

Some problems that go along with renovascular disease can be: heart disease, stroke, heart attack, congestive heart failure, blood vessel damage, kidney failure/damage and loss of vision.

Can renovascular disease be prevented?

No. But, it can be slowed by controlling conditions that can cause it, like hypertension. Eating a healthy diet is always helpful.