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Renal artery stenosis
Alternative namesRenal artery occlusion; Stenosis - renal artery; Occlusion - renal artery; Fibromuscular dysplasia (FMD)
DefinitionRenal artery stenosis is a narrowing or blockage of the artery that supplies the kidney, caused by atherosclerosis, fibromuscular dysplasia of the renal artery wall, or scar formation in the artery. (See also atheroembolic renal disease .)
Causes, incidence, and risk factors
Renal artery stenosis is caused when atheroembolic renal disease results in narrowing of the renal artery. Fibromuscular disease, a condition more common in young women in which fibrous tissue grows in the wall of the renal artery and narrows it, is a second cause. It may also be caused when scar tissue forms in the renal artery after acute arterial obstruction or traumatic injury to the kidney.
Fibromuscular dysplasia is a congenital disorder involving thickening of the arterial wall and is a cause of renal artery stenosis in younger adults, particularly women 20 to 40 years old.
SymptomsThere are usually no symptoms.
Signs and testsThe blood pressure may be high, and there may be a history of hypertension that is refractory or difficult to control. A bruit may be heard on examination with a stethoscope (auscultation) over the kidney.
The treatment varies depending on the extent and severity of the symptoms. If the stenosis results in failure of a kidney, the second kidney may take over filtering and urine production for the body. Surgical repair of the stenosed area may be possible.
A balloon angioplasty (a radiographic procedure during which a balloon-tipped catheter is threaded through the artery) or a stent placement across the stenosis may be an alternative to surgery to open the stenosed area.
Expectations (prognosis)Renal artery stenosis may cause eventual failure of the kidney if it progressively blocks the artery. This may result in chronic renal failure if there is only one functional kidney or if both renal arteries are affected.
Renal hypertension caused by renal artery stenosis may be difficult to treat. Surgical or balloon catheter repair often successfully opens the stenosed area. However, stenosis may recur.
Calling your health care providerIf your history indicates a high risk for renal artery stenosis, make an appointment to see your health care provider. However, decreased urine volume may be an emergency symptom indicating renal failure.
PreventionRenal artery stenosis may be prevented by avoiding smoking.
Update Date: 1/19/2004Irfan A. Agha, M.D., Department of Medicine, St. Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT