Renovascular Conditions

Early detection is very important. As the renal artery blood flow is reduced from stenosis, hypertension or kidney failure may develop.

Renal Vascular Hypertension

Signs and Symptoms
• Recent onset of high blood pressure in young patients
• Young patient without family history of high blood pressure
• Abdominal bruit (loud whooshing sound) on examination
• Predominantly diastolic hypertension with diastolic pressure over 120mmHg
• Patients older than 55 years

1. Recent or sudden onset of high blood pressure
2. Abrupt uncontrollable high blood pressure not responding to treatment

Renal Artery Stenosis - This is a narrowing or blockage of the artery that supplies blood to the kidney. Atherosclerosis (stenosis) normally starts in the abdominal aorta and this plaque obstructs the origin of the renal artery.

Risk factors
• Smoking
• Obesity
• Advanced age
• High cholesterol
• Diabetes
• Family history of cardiovascular disease

Listed below are some causes of stenosis or obstruction of the renal arteries.

  • Fibromuscular Disease – This is when fibrous tissue grows in the wall of the renal artery and narrows it. This is more common in young women.
  • Fibromuscular dysplasia – A congenital disorder involving thickening of the arterial wall and normally in younger adults particularly women 20-40 years old.
  • Aneurysmosis – Renal artery aneurysms which are often associated with atherosclerosis or aneurysm in the other arteries. An aneurysm is when the wall of the artery weakens and expands. Over time this weakened wall can burst like a balloon.
  • Renal arterial thrombosis – This is a sudden severe blockage (blood clot) of the artery that supplies blood to the kidney.
  • Atheroembolic renal disease (AERD) – This is when cholesterol crystals from atherosclerotic plaques break off and move to the kidneys. If severe enough, it may result in end stage renal disease. It may occur after an arteriogram, aortic surgery or placement of stents.

AERD may not have any symptoms. However it can cause the following:

  • Foot pain Ulcers on the feet Pancreatitis Strokes or blindness
  • Pain in the stomach Nausea and Vomiting Flank Pain Uncontrolled high blood pressure