Renal Artery Stenosis

Renal artery stenosis is a narrowing of the right, left, or both renal arteries, which branch off the abdominal aorta and supply blood to the kidneys. It is most common in those over the age of 65, but in rare cases can happen in younger people. The major causes of renal artery stenosis are atherosclerosis, high blood pressure, diabetes, and cigarette smoking.
Patients who have renal artery stenosis may present symptoms of chronic high blood pressure, decreased kidney function, and/or hormone imbalance. Blood tests and routine check-ups can determine if kidneys are properly functioning.
There are numerous tests that can be performed to determine an accurate diagnosis. As for the imaging tests, a patient could have an angiogram, MRI, CT, or doppler ultrasound. An angiogram is the most invasive exam as it is done in an interventional radiology department and entails a catheter being inserted in the patient's groin and contrast injected and watched via live xray as the contrast enters the renal arteries. Although this is more invasive, if there is stenosis, a stent can be placed at the time of the angiogram, thus reducing the need for another procedure. A CT or MR angiogram can also be performed and is much quicker and less invasive. For both exams, intravenous contrast is administered and images are taken in a timed manner to "catch" the contrast as it's entering the renal arteries from the abdominal. Post process procedures can later be done to produced well-defined cut-out images (MIP's) of just the abdominal aorta, renal arteries, and kidneys.
Treatment for renal artery stenosis varies depending on the cause. If high blood pressure is the culprit, the medicines are usually the answer. More invasive/surgical treatments are needed for more serious cases of stenosis. These include an angioplasty and/or placing a stent in the narrowed artery to let blood flow more freely.