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Renal Artery Stenosis

Intro

High blood pressure   is known as the "silent killer." It has no specific symptoms, but over time stresses the major organs in the body and is a risk factor for heart attack   and stroke  .

Blood pressure elevation with renal artery stenosis is no different; however, the decreased blood flow the kidney(s)   over time may cause damage to the kidney(s). Decreased renal function (azotemia), may present with symptoms of fatigue, malaise, and/or slight confusion due to a gradual buildup of waste products in the body.

The healthcare provider may be concerned about renal artery stenosis if high blood pressure has its initial presentation in a person older than age 50 or in a person under the age of 30.

The physical examination may give a clue if a bruit (a rustling sound produced by turbulent blood flow) is heard when the healthcare provider listens to the abdomen. If an artery is narrowed, it may cause turbulence as blood flows through the narrowing, causing a noise, like the rapids in a river. This noise is called a bruit.

Renal artery stenosis may also be considered a cause of elevated blood pressure if multiple anti- hypertension medications have failed to control high blood pressure.

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Follow-up Regardless of the treatment, minimizing risk factors for further artery narrowing is critical. Decreasing the likelihood of further stenosis may be achieved by controlling:

The chance of restenosis is also dependent on the severity of the condition. The more severe the stenosis at the time of diagnosis, the more likely the artery is to completely occlude in the future.

Outlook

Renal artery stenosis is one potential reversible cause of high blood pressure.
The diagnosis may be suspected in patients who have hypertension that is difficult to control.
Diagnosis is made by imaging the artery with ultrasound, computerized tomography, or arteriography.
Treatment may be medical or surgical.
Minimizing risk factors is important in decreasing the risk of restenosis.

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