A.D.A.M. Medical Encyclopedia

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Kidney anatomy


Kidney - blood and urine flow


Kidney blood supply

Renal artery stenosis

Definition

Renal artery stenosis is a narrowing or blockage of the artery that supplies blood to the kidney.

Alternative Names

Renal artery occlusion; Stenosis - renal artery; Occlusion - renal artery; Fibromuscular dysplasia (FMD)

Causes

Renal artery stenosis is caused by:

Abnormal growth or development of the cells in the walls of kidney arteries (fibromuscular dysplasia)
Atheroembolic renal disease
Hardening of the arteries (atherosclerosis)
Scarring of the kidney arteries

Symptoms

There are usually no symptoms.

Exams and Tests

The doctor may hear a loud whooshing sound, called a bruit, when listening to the kidney area with a stethoscope.

A blood pressure reading may be high. The patient may have a history of high blood pressure that is hard to control or does not get better with medicine.

Imaging tests may show that the kidney is smaller or a decrease in blood flow because of a narrowed artery. Such tests may include:

Kidney CT scan
Kidney ultrasound
MRI
Radionuclide renogram

A renal arteriogram shows the exact location of the blocked area.

This disease may also affect the results of the following tests:

Treatment

Treatment depends on the severity of the condition. If only one artery is involved, the second kidney may be able to filter and produce urine.

Surgery may be needed in some cases. Alternatives to surgery include a balloon angioplasty or stenting.

Medications may be needed to control high blood pressure. Renal hypertension caused by this condition may be difficult to treat. For treatment information, see the article on renal hypertension.

Possible Complications

Renal artery stenosis may cause chronic kidney failure if:

It involves both kidney arteries
High blood pressure associated with this condition is severe or continues for a long time

Additional complications:

Malignant hypertension

When to Contact a Medical Professional

Discuss your medical history with your health care provider to determine if you are at risk for this condition.

Decreased urine volume may be an emergency sign of kidney failure.

Prevention

Some cases of renal artery stenosis may be prevented by avoiding smoking.

Safian RD, Textor SC. Renal-artery stenosis. N Engl J Med.2001;344:431-442.

White CJ. Catheter-based therapy for atherosclerotic renal artery stenosis. Circulation. 2006;113:1464-1473.

Balk E, Raman G, Chung M, Ip S, Tatsioni A, Alonso A, et al. Effectiveness of management strategies for renal artery stenosis: a systematic review. Ann Intern Med. 2006;145:901-912.

Textor SC. Renovascular hypertension update. Curr Hypertens Rep. 2006;8:521-527.

Review Date: 4/14/2008
Reviewed By: Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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