Renal Artery Stenosis: All You Need to Know

Cardiology | by Dr. Sabyasachi Pal | Published on 09/01/2023

Renal Artery Stenosis: All You Need to Know

Are you experiencing symptoms like loss of appetite and frequent urination? If yes, then you need to consult the cardiologist in Kolkata as soon as possible. It can indicate renal artery stenosis (RAS), a condition that causes arteries to narrow and carry blood from your heart to the kidneys. If you are not aware of or have much information about the problem, then this write-up is for you. We will cover a detailed discussion on RAS, which includes its symptoms, causes, diagnosis, and treatment options. So, make sure to give it a read till the end.

What is renal artery stenosis?

Renal artery stenosis (RAS) is a condition that occurs because of the narrowing of the arteries that supply blood from your heart to the kidneys. We have two renal arteries supplying blood to the right and left kidneys. There can be stenosis in one or both of these arteries. The renal arteries’ function is to carry blood that is oxygen-rich and helps the kidney get rid of body waste and excessive fluid. This condition causes problems like high blood pressure, kidney failure, and chronic kidney disease.

Who is at risk of renal artery stenosis?

People who have atherosclerosis are identified to be at a greater risk of experiencing renal artery stenosis. Atherosclerosis occurs when plaque is formed on the artery walls. There are other risks factors of renal artery stenosis as well which include:

• Obesity
• High cholesterol and high blood pressure
• Smoking and alcohol
• A poor diet that includes sugar, fat, and high sodium
• Family history of cardiovascular disease
• Diabetes

What are the symptoms of renal artery stenosis?

There are no identifiable renal stenosis symptoms, but you can start noticing the symptoms as the condition develops. Once the condition has progressed, here are the symptoms you are likely to observe:

• Hypertension or high blood pressure even after taking the medications
• Reduced kidney functionalities
• Swelling primarily in your feet and ankles
• Increased proteins in urine
• Loss of appetite and muscle cramps
• Frequent urination
• Sudden and unintentional weight loss

What causes renal artery stenosis?

There are two primary causes of renal artery stenosis which are:

• One of the causes of renal artery stenosis is the buildup of plaque in the artery walls and the kidney walls which include fats, cholesterol, and other substances. If the deposits get larger, then it becomes harder to regulate blood flow, causing kidney scarring and artery narrowing. Atherosclerosis occurs in different body parts and is known to be a common cause of renal artery stenosis.
• Fibromuscular dysplasia is another common cause of renal artery stenosis. The muscle in the artery wall doesn’t develop the way it should in fibromuscular dysplasia. This problem usually occurs in childhood. The renal artery comprises a narrow section substituting with broader sections which give a bead-like appearance in the artery images.

The renal artery can narrow so extensively that it becomes harder to get enough blood and as a result, one can experience high blood pressure problems at a very young age. This issue can occur in one or sometimes both kidneys. Specialists aren’t sure of the reasons behind fibromuscular dysplasia, but this condition is more common among females and can be congenital.

There are other causes of renal artery stenosis as well which include blood vessel inflammation or growth that develops in the abdomen.

How is renal artery stenosis diagnosed?

There are times when a healthcare expert might detect or diagnose renal artery stenosis incidentally. It means that the doctor has diagnosed this disease while diagnosing or treating another condition. If your doctor suspects RAS, then they might perform the following tests:

• A physical evaluation is the first step in diagnosing the condition. The doctor will check your blood pressure and look for signs of swelling in your limbs and listen to your breathing pattern. He/she might also use a stethoscope near the kidneys so that they can listen to the blood flowing through your arteries. It will assist the doctor to confirm RAS.
• Kidney function tests will be ordered which include urine and blood tests. It will detect whether the kidneys are working fine or not. The increased levels of substances such as nitrogen, creatinine, protein, and waste products in the body fluids show that the kidneys are not filtering out waste from the blood effectively.
• Imaging scans are also recommended such as computerized tomography angiography (CTA), renal scan, magnetic resonance angiogram (MRA), and duplex ultrasound. All these imaging tests will help in evaluating the kidney size and how well the blood is being supplied to your kidneys.

How is renal artery stenosis treated?

The treatment of Renal Artery Stenosis involves medications and lifestyle changes. 

One of the ways to treat this condition is with medications. Your doctor will recommend some medications which will help you in relaxing the blood vessels so that they are not narrowed. Here are the medications:

• Angiotensin-converting enzyme inhibitors (ACE).
• Angiotensin II receptors blockers (ARBs)
• Calcium channel blockers

Beta-blockers and alpha-beta-blockers are also recommended as these drugs help minimize blood vessel dilation. Diuretics are also recommended for reduced fluid retention and swelling.

Lifestyle changes

The best treatment you can consider is making certain lifestyle changes along with medications including:

• Getting regular exercise at least 30 minutes a day.
• Make sure to maintain weight or lose weight, if needed
• Quit alcohol and smoking
• Cut back on caffeine
• Manage stress
• Get enough sleep
• Consume less sodium

Procedure

If medication and lifestyle changes aren’t helpful to treat RAS or restrict the effects, then the situation can go out of hand. In such cases, the doctor might recommend procedures for improving the arterial function otherwise it can damage the kidneys. The procedure recommended for RAS involves renal stenting and bypass surgery.

Conclusion

Renal artery disease is a progressive condition and keeps deteriorating over time. The outlook of this disease for someone relies on its severity. According to research, it is found that once diagnosed with this condition around 48% of people can survive for four years. It is a serious condition causing permanent kidney damage. If you have been diagnosed with this disease, it is crucial to consult your cardiology doctor immediately and it is more important to consider treatment if you have an underlying condition like hypertension.

FAQs

 

When should you contact your healthcare provider about renal artery stenosis disease?

You should get in touch with the healthcare provider if you experience signs like a metallic taste in your mouth, abdominal pain, low urine output, nausea, seizures, vomiting, and swelling in your legs, arms, or face.

Does renal stenting cure renal artery stenosis?

In most cases, the renal stenting procedure or angioplasty doesn’t cure RHA disease, however, it can help in slowing down the progress of the disease.