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Vascular Surgery - Renal Artery Disease

The kidneys are organs located on either side of the abdomen. The main function is to clear waste from the body through the production of urine. If the kidneys stop working the body will accumulate the waste. The renal arteries are the arteries that carry blood flow to the kidneys. With age and lifestyle the arteries can become hard and narrowed reducing the blood flow needed by the kidneys. The reduced blood flow can seriously damage the kidneys and cause complications such as high blood pressure and renal failure.

Symptoms

The main symptom related to renal artery narrowing is high blood pressure that is difficult to control with medicine.

Untreated high blood pressure may lead to:

  • Severe headaches
  • Ringing in the ears
  • Heart failure
  • Stroke.
  • Kidney failure requiring dialysis.

Causes:

  • Cholesterol and plaque build-up also known as Arteriosclerosis. 
  • Congenital narrowing of the arteries that occur during the development of the baby.
  • Fibromuscular dysplasia (FMD), overgrowth of tissue inside the renal artery, usually affects women 20 to 40 years old.

Diagnosis:

The initial test is usually a duplex ultrasound which looks at the renal arteries and the flow of blood within the arteries. The test is preformed in the doctor's office or the vascular laboratory and takes about 20 minutes to complete.

Your doctor may also choose to order other tests if more information is needed, these tests include:

-CT scan

-MRA (Magnetic Resonance Angiography)

-Angiogram

Treatment:

Early cases of renal artery narrowing can be treated with lifestyle changes such as:

Smoking cessation

Regular exercise

Well controlled diabetes and high blood pressure.

Certain cases may require a procedure to improve the blood flow. These procedure include:

Angioplasty and stenting- A balloon is placed in the artery and expanded to open up the artery. Occasionally a stent is used if the balloon fails to keep the artery open. The patient typically goes home several hours after the procedure.

Surgery- surgery may be needed in cases that can not be treated with an angioplasty and stent. The surgery consists of either removal of the disease that is causing the narrowing or a bypass using an artificial graft or a vein from the patient's own leg. 

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