Renal artery stenosis is a blockage of an artery to the kidneys, which may ultimately lead to kidney failure and hypertension (high blood pressure). In most cases, this blockage is caused by atherosclerosis, the build-up of cholesterol deposits (plaque) in arteries, but also may be caused by conditions such as fibromuscular dysplasia, which involves abnormal cellular development in artery walls, and Takayasu's arteritis, an inflammatory disease that affects the aorta and its branches, including the renal arteries.
The Brigham and Women’s Hospital (BWH) Division of Vascular and Endovascular Surgery provides advanced diagnosis and treatment for patients with renal artery disease. State-of-the-art techniques, including endovascular treatment of renal artery stenosis, are available for our patients. Part of the Heart & Vascular Center, we are an international referral site with broad experience managing vascular problems, ranging from the most common to the rare and complex. Twenty-four-hour consultation is available for urgent or emergency problems.
- Risk Factors for Renal Artery Stenosis
- Symptoms of Renal Artery Stenosis
- Diagnosis of Renal Artery Stenosis
- Treatment for Renal Artery Stenosis
- What You Should Expect
- Multidisciplinary Care
- Appointments and Locations
There are a variety of factors that could put you at risk for developing renal artery stenosis; the most common are:
- Advanced age
- Gender – women are at higher risk
- High cholesterol
- Hypertension, particularly new onset of hypertension in an older person
Keep in mind that although these factors increase a person's risk, they do not necessarily cause the disease. A patient with several of these risk factors may never develop the disease, while others with no known risk factors may develop the disease.
Common symptoms of renal artery stenosis include:
- Sudden onset of hypertension
- Hypertension not responsive to three or more blood pressure medications
- Increased urea (waste product excreted by the kidneys) in the blood
- Unexplained kidney failure
- Sudden kidney failure upon first taking an angiotensin-converting enzyme (ACE) inhibitor medication
- Recurrence of flash pulmonary edema (FPE), a build-up of fluid in the lungs
Our renal artery stenosis specialists provide expert evaluation and diagnosis with the aid of the latest in advanced imaging technologies:
Specialists from the Division of Vascular and Endovascular Surgery develop individualized treatment plans for renal artery stenosis patients based on:
- Overall health
- Medical history
- Severity and form of the disease
- Tolerance for specific medications or procedures
- Expectations for course of the disease
- Presence of other conditions
The first option is to treat peripheral arterial disease medically. Along with a modification of lifestyle risk factors, this may include:
- Antiplatelet medications (to reduce clots)
- Antihyperlipidemics (to lower fats in the blood)
- Antihypertensives (to lower blood pressure)
Procedures and Surgery
If it is determined that renal function is extremely impaired and medical treatment has failed to control hypertension, interventional (minimally invasive) or surgical treatment will be recommended.
- Renal angioplasty and stenting
- Renal artery bypass
- Renal endarterectomy
- Peripheral bypass surgery
The Heart & Vascular Center is located in the Shapiro Cardiovascular Center, across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.
If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests.
The day of your procedure, you care will be provided by physicians, anesthesiologists and nurses who specialize in surgery for patients with renal artery stenosis. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.
During your procedure, family and friends can wait in the Shapiro Family Center. Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.
Patients benefit from the teamwork of vascular and endovascular surgeons, medical cardiologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in peripheral artery disease. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.
Visit the Kessler Health Education Library in the Bretholtz Center where patients and families can access computers and knowledgeable staff.
Visit the Brigham and Women’s Hospital HealthHub Blog, which features information on a variety of topics, including vascular disease.
This page was last modified on 5/24/2016