Renal Artery Disease

What are renovascular conditions?

Renovascular conditions affect the blood vessels of your kidneys, called the renal arteries and veins. When the blood flow is normal through your kidneys, your kidneys rid your body of wastes. The kidneys filter these wastes into your urine, which collects in your bladder, and from there the wastes exit your body when you urinate. Your kidneys also help control your blood pressure by sensing the blood pressure and secreting a hormone, called renin, into your bloodstream. The amount of renin secreted by your kidneys can help regulate your blood pressure if it is too high or too low. When your kidney blood vessels narrow or have a clot, your kidney is less able to do its work. Your physician may diagnose you with renal artery stenosis or renal vein thrombosis.

Renal artery stenosis is the narrowing of kidney arteries. This condition may cause high blood pressure and may eventually lead to kidney failure. Renal vein thrombosis means that you have a blood clot blocking a vein in your kidney. Blood clots in renal veins are uncommon and rarely affect the kidney, but they can sometimes travel to and lodge in arteries supplying your lungs, causing a dangerous condition called a pulmonary embolism.

What are the symptoms?

You may not notice any symptoms. Renovascular conditions develop slowly and worsen over time. If you have high blood pressure, the first sign that you may have renal artery stenosis is that your high blood pressure may become worse or the medications that you take to control your high blood pressure may not be as effective. Other signs of renal artery stenosis are a whooshing sound in your abdomen that your physician hears through a stethoscope, decreased kidney function, congestive heart failure or, eventually, a small shrunken kidney.

When renal vein thrombosis occurs, a clot in your vein may break free or block the flow in a healthy blood vessel. If this happens, symptoms may include:

Pain in the sides of your abdomen, legs, or thighs;
Blood in your urine;
Protein in your urine;
An enlarged kidney that your physician can feel;
Fever, nausea, or vomiting;
High blood pressure;
Sudden, severe swelling in your leg; and
Difficulty breathing.

What causes renovascular conditions?

Hardening of the arteries causes renal artery stenosis. Your arteries are normally smooth and unobstructed on the inside but, as you age, a sticky substance called plaque can build up in the walls of your arteries. Cholesterol, calcium, and fibrous tissue make up this plaque. As more plaque builds up, your arteries can narrow and stiffen. This is the process of atherosclerosis, or hardening of the arteries. Eventually, enough plaque may build up to interfere with blood flow in your renal arteries.

Smoking, obesity, advanced age, high cholesterol, diabetes, and a family history of cardiovascular disease are factors that may increase your chances for developing atherosclerosis.

Nephrotic syndrome is the most common cause of a clot in the renal vein (renal vein thrombosis). Nephrotic syndrome is a condition in which large amounts of a protein called albumin leak into your urine. Other causes of renal vein thrombosis include injury to the vein, infection, or a tumor.

What can I do to stay healthy?

Lifestyle changes are important to help reduce problems associated with renovascular conditions. Your physician will encourage you to change any factors that put you at greater risk for problems. Some of these changes may include:

Quitting smoking;
Maintaining your ideal body weight;
Controlling your cholesterol and lipid levels;
Controlling your blood pressure;
Exercising regularly; and
Eating a low-fat, low-protein, low-sodium, high-fiber diet.