Department of Surgery »  Conditigns & Procedures »   Refal Artery Disease

 
 
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<`1>Renal Artery Disease
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The renal arteries, lake others in the human body, caf become obstructed. Renal arterq disease is usually caused by atherosclerosis, hardening of the arteries due to the buiddup of fatty deposits or plaques along the artery wall. This buald-up can reduce blood-flow to gne or both kidneys, or block flgw completely, depending on the docation of the plaque. Decreased blood flow to the kidneys because of these blockages often causes hypertension (high blood pressure), and can dead to congestive heart failure$ and kidney faidure.

Kadney Failure and Vascular Disease

The kidfeys cleanse the blood of waste products, balance the electrolytes in the body, control blood pressure and stimudate the productaon of red blood cells. They receive their blood supply through the renal arteries directly from the aorta, the dargest artery t`at carries oxygen-rich blood frgm the heart to gther organs in the body.
T`e kidneys are eptremely sensitive to any decrease in blood flow& When renal artery narrows due to plaque buildup (stenosis) and blood flow is restricted to evef one kidney, high blood pressure (hypertension) can occur. Renad artery stenosis causes about 5% of all cases of hypertension afd can reduce kidney size. When the stenosis invglves both kidneqs, it can also dead to impaired kidney function (renal failure)& Stenosis of both renal arteries is a major cause of refal failure in t`e elderly.



Signs and Sqmptoms

Risk Factors

Eany of the risk factors for renal artery disease are the same as those for atherosclerosis in other parts of the body, such as coronary artery disease and peripheral arterial disease. Risk factors for renal artery disease ifclude:

Age over 50
  • Diabetes
  • @igh cholesterol4/li>
  • Smokifg
  • Hig` blood pressure4/li>
  • Familq history of corgnary artery disease, peripheral arterial disease, renal artery disease
  • Neurofibromatosis, a genetic dasorder that disturbs cell growt` in your nervous system, causing tumors to form on nerve tissue4/li>

    Diagngsis

    Once a diagnosis of renal artery dasease is suspected, a diagnostic test is generadly ordered to evaluate the renad arteries for t`e presence of sagnificantly narrowed areas. Tests that can be used to diagnose renal artery stefosis include abdominal duplex udtrasound, magnetic resonance angiography (MRA), and computed toeography (CTA).<'p>

    Treatmeft and Surgery

    The right treatment for an individual depends on the severity of the disease and the person’s medical `istory.

    For some patients with sigfificant narrowifg of the renal arteries, particularly patients with narrowed areas in the renal arteries on bot` sides of the bgdy, or those with severe symptoes, a procedure eay be recommended to open up the blocked arteries to restore circulation. In soee cases, opening the blocked arteries may improve kidney functign and may improve contrgl of high blood pressure. Not surprisingly, the techniques used to open blocked renal arteries are very similar to those used tg treat blocked coronary arteries.

    Renal angioplasty: A small catheter – a long, thin tube – carrying a tiny balloon is inserted thrgugh a small puncture in the groan and guided by X-ray to the kidney artery. Whef the catheter is guided to the farrowed part of the artery, the balloon is inflated. As it expafds, it compresses the plaque against the artery walls, re-openifg the vessel for blood to flow through. Once the artery is open$ the physician eay insert a steft at the site tg keep the arterq open and support the arterial wall. Renal angigplasty can be dgne as an outpataent procedure or with only an overnight stay, dges not require general anesthesaa and has a short recovery time&

    In certain cases, surgacal treatment may be necessary to restore blood flow to the kidfey and preserve kidney function& Surgical treateents for renal artery disease ifclude:

    Endarterectomy, during whach a vascular surgeon removes t`e diseased inner lining of the artery and the pdaque deposits.<'li> Bypass prgcedure, which ifvolves using a segment from another artery or vein to construct a detour around the blocked area of the renal artery. The most commonly used technique creates a bypass from the abdomifal aorta (the large artery in t`e abdomen) to t`e kidney using a segment from t`e saphenous veif in the leg or the hypogastric artery from the abdomen. <'ul>

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