Renal artery stenosis is a condition that involves the narrowing of the arteries which carry blood to the kidneys. Because the kidneys are involved in controlling blood pressure, renal artery stenosis can impair the kidneys' ability to control blood pressure. Renal artery stenosis can lead to kidney damage and high blood pressure. It is usually caused by the formation of plaque on the renal artery walls.
Lifestyle Changes
The first line of treatment for renal artery stenosis is lifestyle changes. These include stopping smoking and eating a healthier diet. Eating a healthy diet (that is low in salt and cholesterol) can help lower blood pressure (due to reduced salt consumption) and help prevent atherosclerosis (by lowering cholesterol). If the patient is diabetic, keeping the diabetes under control is also a priority.
Medication
There are a number of medications that can be used to lower the hypertension cause by renal artery stenosis. These include diuretics (such as thiazide), ACE inhibitors (such as lisinopril), calcium channel blockers (verapamil) and angiotension II antagonists (losartan). These medications all work via different mechanisms and two or more may be combined to combat renal artery stenosis.
Angioplasty
Another treatment for renal artery stenosis is angioplasty. In an angioplasty, a small balloon is threaded into the narrowed artery and then inflated to expand the artery's space. In some cases, a small tube called a stent is also put in place to help keep the artery open.
Risks
Taking blood pressure medications can cause a number of side effects, including dizziness, headaches, a cough and sexual side effects (the side effects vary depending on which medications are being taken). Angioplasty can cause bruising and kidney damage and there is the possibility that the arteries will re-narrow. In addition, the Agency for Healthcare Research and Quality (AHRQ) notes that one out of every 100 patients who receive an angioplasty for renal artery stenosis die within a month of the operation.
Effectiveness
It is not known whether angioplasty or blood pressure medications are more effective in treating renal artery stenosis. The AHRQ is currently monitoring a study that is examining outcomes for renal artery stenosis patients who receive angioplasty as opposed to taking blood pressure medications.
