Renal artery stenosis denotes a condition in which there is the narrowing of the lining of the main artery that supplies the kidney. Depending on the degree of narrowing, patients can develop hypertension called renal vascular hypertension. This form of hypertension is the most common cause of secondary hypertension (elevated blood pressure caused by another disease). When renal artery stenosis has narrowed the artery about 70%, Renal Vascular hypertension may occur. Reduced blood flow through the renal artery causes the kidney to release increased amounts of the hormone renin. Renin, a powerful blood pressure regulator, initiates a series of chemical events that result in hypertension. Renal vascular hypertension can be very severe and difficult to control. The kidney that is affected with renal artery stenosis often shrinks in size. The process is called ischemic nephropathy. The other kidney is at risk for developing damage from the hypertension. Often developing hypertensive nephrosclerosis. The persistent elevated blood pressures in this non-stenotic kidney can cause progressive scarring (sclerosis) leading to progressive loss of filtering function in this kidney as well. Both Renal vascular hypertension and Renal artery stenosis can lead to renal failure. Renal vascular disease accounts for less than 1% of all hypertension in people who have moderately increased blood pressure. But in certain high-risk groups, renal vascular disease may be the cause of 10% to 40 % of all hypertension. FMD RAS occurs almost exclusively in women aged 30 to 40 and rarely affects African Americans or Asians.
Causes of Renal Artery Stenosis
Several distinct conditions may lead to Renal artery stenosis. These include arteriosclerotic vascular disease, Fibromuscular disease and scarring from acute obstruction of the kidney or from direct trauma to the kidney. In the elderly, renal artery stenosis is most commonly associated with atherosclerotic disorders, including atherosclerotic heart disease. Atherosclerotic plaque deposits within the renal artery and causes it to become narrowed. Fibromuscular dysplasia is a congenital disorder involving thickening of the arterial wall and is a cause of renal artery stenosis in younger adults, particularly women 20 to 40 years old.
Signs and Symptoms of Renal Artery Stenosis
Usually, there are no symptoms associated with renal artery stenosis. If the condition arises from arteriosclerotic vascular disease, there may be associated disease in the arteries serving the legs and heart. This may lead to leg pain and weakness as well as chest pain or shortness of breath, particularly with exercise. The blood pressure may be high, and there may be a history of hypertension that is refractory or difficult to control.
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Medical Content Last Updated on 07/12/2008
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