The renal arteries, which supply blood to the kidneys, are vulnerable to the same buildup of plaque that affects arteries in the legs and other areas of the body.
When the fats, cholesterol and other substances that form plaque start narrowing or blocking the pathway through the arteries, it restricts the amount of blood moving in and out of your kidneys.
Renal artery disease can cause high blood pressure, clotting, aneurysms, congestive heart failure and kidney failure. This disease is not as common as peripheral artery disease, caused by the same artery-clogging condition known as atherosclerosis, but it is no less serious.
Symptoms
If you have a renal artery blockage or an aneurysm – the weakening and bulging of an artery – you might not even feel it.
But various types of renal artery disease can produce pronounced effects.
Renal artery stenosis, the narrowing or blocking of an artery:
- High blood pressure.
- Kidney failure.
- Renal artery thrombosis, a blood clot in an artery leading to the kidney:
- Fever.
- Blood in urine.
- High protein levels in urine.
- Pain in the rib area and the upper reaches of the hip bone.
- Nausea/vomiting.
- High blood pressure.
- Excess fluid, swelling in body tissue.
- Reduced kidney function.
Atheroembolic renal disease, when plaque fragments break free from arteries above the kidney and block the organ’s small blood vessels:
- Blood in urine.
- Fever.
- Headache.
- Muscle aches.
- Weight loss.
- Abdomen pain.
- Nausea/vomiting.
- Foot pain.
- Sores on feet.
- Discolored (blue) toes.
- Side pain.
- High blood pressure.
Renal artery aneurysm, the weakening and bulging in the wall of an artery that leads to the kidney:
- High blood pressure.
- Side pain.
- Blood in urine.
Causes
Renal artery disease is often linked to the similar peripheral artery disease – atherosclerosis in arteries beyond the heart – or coronary artery disease.
Up to 90 percent of cases are related to the artery-clogging atherosclerosis.
Other causes:
- Fibromuscular dysplasia (hereditary).
- Aneurysm.
- Tumor.
- Certain medications.
- Surgery.
- Infection.
- Injury.
- Inflammatory disease.
Treatment
Your age, health, the severity of your condition and your body’s receptiveness to specific procedures, therapies or medications will influence your doctor’s plan.
After a physical exam, blood and urine tests and a review of your medical history, your doctor also might order:
- CT scan.
- Magnetic resonance angiography.
- Doppler ultrasound.
- Renal arteriography.
Renal Artery Stenosis
Lifestyle changes
- Exercise regularly.
- Reduce salt intake.
- Reduce stress.
- Nutritional diet.
- Moderate, or eliminate, use of alcohol and caffeine.
- Stop smoking.
Medications
ACE (angiotensin-converting enzyme) inhibitors: Lower blood pressure.
Angiotensin II receptor blockers: Lower blood pressure by relaxing blood vessels.
Beta blockers: Slow heart rate, lower blood pressure.
Diuretics: Reduce fluid buildup in lungs and associated swelling in ankles and feet.
Calcium channel blockers: Relaxes blood vessels, making it easier for the heart to pump blood.
Procedures
Angioplasty/stenting: A tiny balloon inserted into the narrowed artery, then inflated, widens the artery. A stent, a wire mesh coil, often is used to keep the artery open.
Endarterectomy: Removes plaque buildup (atherosclerosis) from the walls of blood vessels.
Bypass surgery: A replacement blood vessel is grafted to the renal artery, creating a new path for blood to the kidney.
Renal Artery Thrombosis
Medications
Thrombolytics: Help dissolve the blood clot.
Procedures
Sometimes it’s necessary to either remove the clot or bypass the artery, depending on the clot’s size.
Atheroembolic Renal Disease
Lifestyle Changes
- Adjust diet to reduce fats.
- Reduce cholesterol.
Medications
Because atheroembolic kidney disease does not respond particularly well to treatment, your doctor might prescribe medications to lower blood pressure and reduce lipid and cholesterol levels. Your doctor’s priority will be minimizing organ damage.
Procedures
Angioplasty/stenting: A tiny blloon inserted into the narrowed renal artery, then inflated, widens the artery. A stent, a wire mesh coil, often is used to keep the artery open.
Renal Artery Aneurysm
A renal artery aneurysm, if small, is monitored with CT scans.
Medications
Most cases are treated with blood-pressure medications.
ACE (angiotensin-converting enzyme) inhibitors: Lower blood pressure.
Angiotensin II receptor blockers: Lower blood pressure by relaxing blood vessels.
Beta blockers: Slow heart rate, lower blood pressure.
Procedures
A large aneurysm, depending on its location, is repaired with stents or surgery.
Because pregnancy increases the risk of an aneurysm rupture, a woman with an aneurysm of any size and who may become pregnant should talk to her doctor about repair options.