RENAL ARTERY STENOSIS: Causes, Signs and Treatment!
WHAT IS RENAL ARTERY STENOSIS?
Renal Artery Stenosis Definition: A renal artery stenosis is a narrowing of the large renal vessels, ie, the arteries, which supply the kidneys with blood.
WHAT ARE THE MAIN CAUSES OF RENAL ARTERY STENOSIS?
Renal Artery Stenosis Causes: Renal artery constrictions have a frequency of about 1% with mildly elevated blood pressure. If the blood pressure is low, 4 – 4.5%. In approximately 20-30% of patients with a diagnosed renal artery stenosis on one side, bilateral constrictions occur.
Usually, constrictions are acquired in the course of life (arteriosclerosis). Congenital narrowings are rare (<1%). Of these, women are more often affected than men. The risk factors include, on the one hand, factors that are not changing such as an increasing age, but also diseases such as diabetes mellitus, hypertension and fat metabolism disorders. Other factors such as smoking, unhealthy diet and physical and mental stress also increase the risk of arterial constriction.
WHAT ARE THE SYMPTOMS OF RENAL ARTERY STENOSIS?
Renal Artery Stenosis Symptoms: The first thing the patient is aware of is the high blood pressure. The reason for this is that the kidney notes that it receives too little blood, and therefore ejects hormones, eg the renin, which leads to a blood pressure increase. The blood pressure can continue to rise – a devil’s circle.
As a result, poor blood flow to the kidneys leads to renal shrinkage and loss of function. The blood pressure hormone renin, however, is still distributed with a functioning kidney. The hypertension is retained. However, production of the hormone for blood formation is discontinued. It comes to the blood glut (anaemia).
HOW IS RENAL ARTERY STENOSIS TREATED?
Renal Artery Stenosis Treatment: The most important diagnostic method (gold standard) is arterial angiography, which is performed by means of an arterial puncture in the groin. With this method, an expansion of the throat from the inside can also be carried out in the same session by means of an inserted balloon ( percutaneous transluminal angioplasty ). In addition, today this method is combined with the use of a wire mesh (stent). The result is that the vessels do not contract again due to their elastic properties. The vessel is supported by this endoprosthesis and kept open. An expansion of the renal artery constriction should occur if the vessel is constricted by more than 60%.
- The Success of balloon stretching or stent implantation: The invasive method can be performed safely and successfully in a renal artery stenosis. A permanent elimination of the throat is possible in more than 95% of the patients. In 40 – 50% of the cases, there is at least an improvement in the blood pressure situation. However, recent studies have shown that the blood pressure situation does not improve in some patients, despite the fact that the blood pressure has been dilated. This has resulted in kidney damage as a result of the long duration of the high blood pressure and the lower blood flow to the kidneys. Patients who have not developed the renal arteries narrowly or have only moderately affected the blood pressure situation also benefit from the fact that the blood pressure can then be treated much better with medication and ACE inhibitors can be used.
- For the kidney unfavourable medication for diagnosed Renal Artery Stenosis: No ACE inhibitors or AT I / AT II antagonists may be given for the treatment of elevated blood pressure values in the case of diagnosed renal artery constriction, as this therapy may lead to a chronic or acute deterioration of the renal function and simultaneous administration of water tablets. This can lead to a loss of renal function in the worst case.
HOW CAN RENAL ARTERY STENOSIS BE PREVENTED?
Usually not when a renal artery stenosis is inherited. In the case of renal artery stenosis due to arteriosclerosis (vessel limescale), the deterioration of an existing throat can be prevented by drastically reducing the risk factors. Also, people whose families have accumulated heart attacks and strokes should look for a healthy lifestyle and avoid stress.