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Diagnosis / Renal Artery Hypertension

Renal hypertension is a condition caused by renal artery stenosis, which is the narrowing or blockage of the two arteries responsible for supplying blood to the kidneys. When the normal blood flow is slowed by stenosis, it signals a hormonal response in the kidneys. If the renal arteries are functioning properly and there is adequate blood flow, these hormones keep your blood pressure regulated. But when the blood flow is reduced by stenosis, the hormonal response triggers an increase in blood pressure to the entire circulatory system.

Causes of Renal Hypertension

There are two arteries responsible for delivering blood to the kidneys. If one or both of the renal arteries are narrowed or completely blocked due to renal artery stenosis, the result is renal hypertension.

When the renal arteries are functioning as they should, they help the body stave off dehydration. Low blood flow means that the body is low on water, so the kidneys release hormones that tell your body to retain salt and water. Once the additional fluid fills your blood vessels, it increases your blood pressure throughout your body, resulting in hypertension.

Nearly 90 percent of cases of renal artery stenosis and hypertension are caused by atherosclerosis. Atherosclerosis is the hardening of the arteries as a result of a buildup of plaque inside the artery walls. This condition is the same process that can lead to heart disease, heart attack or stroke, as not enough oxygenated blood is getting to your organs to keep them healthy and functioning correctly. If renal stenosis and renal hypertension remain untreated, you may be left with severe kidney damage.

Another less common cause of renal artery stenosis is known as fibromuscular dysplasia. This is a condition where the structures of your renal arteries have developed abnormally, causing them to be narrow and reducing blood flow to the kidneys.

Symptoms of Renal Hypertension

Like regular hypertension, unless your blood pressure is dangerously high, renal hypertension can exist without causing symptoms. There is no way to feel if your arteries are narrowed, and high blood pressure may be attributed to stress or diet. If your blood pressure is extremely elevated, you may experience:

  • Headache
  • Blurred or double vision
  • Nosebleed
  • Confusion
  • Blood in your urine

Again, the majority of patients never have these or any other symptoms, which makes this condition particularly dangerous, as organ damage can happen slowly without being noticed.

Risk Factors for Renal Artery Hypertension

Because high blood pressure can be attributed to several other, more common factors, renal artery hypertension is often discovered by accident during tests conducted to identify other conditions. However, you may want to consider getting screened if you have one or more of the following risk factors:

  • Advanced age
  • Gender (more common in females)
  • Existing hypertension
  • High cholesterol
  • Diabetes
  • Vascular issues such as peripheral or coronary artery disease
  • Chronic kidney disease
  • You are a smoker

Doctors may suspect that you have renal artery hypertension if your blood pressure is uncontrolled even with the use of multiple medications for hypertension, or if you develop chronic kidney disease. Renal hypertension can eventually lead to chronic kidney disease, which is another condition that is often advanced before any symptoms appear.

Diagnosis and Treatment

Like other artery conditions, renal artery hypertension can be diagnosed using an ultrasound, CT scan, MRI or angiogram. Once you are diagnosed, the first step toward controlling your elevated blood pressure is medication. However, if one or more medications are not doing the trick, it may be time to explore surgical options. Common treatments include those used to treat coronary artery disease, including angioplasty or the placement of a stent to open up the blocked artery, or in more severe cases, bypass surgery.

If you have been diagnosed with renal artery hypertension, or want to undergo a preventative screening, call IVC today at 503-612-0498 to schedule an appointment with one of our team of experienced and professional interventional radiologists.

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Jason Bauer, MD RVT
Michael Pfister, MD RVT

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