Renal artery stenosis
| Renal artery stenosis | |
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| Classification and external resources | |
| Specialty | cardiology |
| ICD-10 | I70.1 |
| ICD-9-CM | 440.1 |
| DiseasesDB | 11255 |
| MedlinePlus | 001273 |
| eMedicine | med/2001 |
| MeSH | D012078 |
Renal artery stenosis is the narrowing of one of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney, resulting in renovascular hypertension – a secondary type of high blood pressure. Possible complications of renal artery stenosis are chronic kidney disease and coronary artery disease.
Most cases of renal artery stenosis are asymptomatic, and the main problem is high blood pressure that cannot be controlled with medication. Decreased kidney function may develop if both kidneys do not receive adequate blood flow, furthermore some people with renal artery stenosis present with episodes of flash pulmonary edema.
Renal artery stenosis is most often caused by atherosclerosis which causes the renal arteries to harden and narrow due to the build-up of plaque. This accounts for about 90% of cases with most of the rest due to fibromuscular dysplasia. Fibromuscular dysplasia is the predominant cause in young patients, usually females under 40 years of age.
The pathophysiology of renal artery stenosis, leads to changes in the structure of the kidney that are most noticeable in the tubular tissue. If the stenosis is longstanding and severe, the glomerular filtration rate in the affected kidneys never recovers and (prerenal) kidney failure is the result.
Changes include:
The diagnosis of renal artery stenosis can use many techniques to determine if the condition is present, a clinical prediction rule is available to guide diagnosis.
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