Renal Vascular Disease

The kidneys need a good blood supply to function well. The main artery that takes blood to the kidneys is called the renal artery. (Renal means kidney.)

Renal vascular disease is any of a number of conditions that limit blood flow in and out of the kidneys. These conditions can affect the renal artery, or the smaller arteries going to the kidneys. They conditions can lead to kidney damage or kidney failure.

Symptoms of renal vascular disease can include:

• Symptoms of high blood pressure, including bad headache, changes in vision, or nausea
• High blood pressure that gets worse and is hard to manage with medicines
• Symptoms of kidney failure, including belly pain, sudden decrease in urine (pee), blood in the urine, or pain in the side

If blood flow to only 1 of the kidneys is blocked, you may not have symptoms because the other kidney can do the work. If both kidneys have reduced blood supply, this can cause acute kidney failure, which requires kidney transplant or dialysis.

See your healthcare provider if you:

• Have a bad headache along with nausea or vomiting, confusion, or changes in vision.
• Stop producing urine (pee).
• Have sudden pain in the back, side, or belly.
• Think you have high blood pressure that has not been treated, or your treatment is not working.

Renal vascular disease happens when the arteries that carry blood to the kidneys become narrowed or blocked because of:

• High blood pressure due to narrowing of the arteries that carry blood to the kidneys. This is called renal artery stenosis (sti-NOH-sis) or renovascular (ree-noh-VAS-kyuh-ler) hypertension. It’s most often caused by high cholesterol, which leads to plaque buildup in the walls of the arteries (atherosclerosis—ath-uh-roh-skluh-ROH-sis). This kind of high blood pressure can be hard to treat and can also increase the risk of a sudden blockage.
• Sudden blockage by a blood clot or plaque from a larger artery that breaks off and travels through the bloodstream toward the kidneys. This can lodge in the renal artery or one of the smaller arteries to the kidneys. This is called a renal artery embolism (EM-buh-liz-um).
• Sudden blockage from a blood clot in an artery that carries blood to the kidneys. This is called renal artery thrombosis (throm-BOH-sis).
• Diabetes
• Family history of heart disease
• Certain heart conditions including mitral stenosis and atrial fibrillation
• Older age

Lifestyle activities that can contribute to these conditions include:

• Smoking
• Heavy alcohol use
• Not getting enough physical activity

To find out if your symptoms are caused by renal vascular disease, your healthcare provider will do physical exam and ask about your medical history. They may also order tests, including:

• Blood tests to check cholesterol and other levels
• An ultrasound of the kidneys or the arteries going to the kidneys
• An MRI imaging test with contrast dye to show the of the arteries going to the kidneys
• A renal angiogram, which is another imaging test that can show the location of a blockage;

Treatment depends of the type of renal vascular disease you have as well as your age and other health conditions. It may include:

• Medicines to treat blood pressure or cholesterol
• Treatment for a related condition such as diabetes
• Medicines to dissolve a blood clot
• Medicines to prevent blood clots such as warfarin
• Surgery to remove a blood clot, bypass an artery, or repair an artery

Not all conditions that lead to renal vascular disease can be prevented. To reduce your chances, you can:

• Have regular wellness visits. Have your cholesterol and blood pressure checked and treated as needed.
• Quit smoking (if you smoke).
• Eat a heart-healthy diet.
• Get regular exercise.
• Surgery to remove a blood clot, bypass an artery, or repair an artery

Renal vascular disease is a condition that limits blood flow to the kidneys. It can be caused by narrowing of the arteries or a blockage in an artery to the kidneys. This can lead to kidney damage or kidney failure.