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Renal artery stenosis (RAS) is the narrowing of one or both of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney , resulting in renovascular hypertension – a secondary type of high blood pressure .
"Hypertensive" refers to high blood pressure and "nephropathy" means damage to the kidney; hence this condition is where chronic high blood pressure causes damages to kidney tissue; this includes the small blood vessels, glomeruli, kidney tubules and interstitial tissues. The tissue hardens and thickens which is known as nephrosclerosis. [2]
It is thought that decreased perfusion of renal tissue due to stenosis of a main or branch renal artery activates the renin–angiotensin system. [8] [9] [10] There are two main causes of renovascular hypertension: renal artery stenosis and fibromuscular dysplasia. [citation needed]
Renovascular hypertension is caused by diminished blood flow to one or both kidneys. As a result, the kidneys release hormones that cause the body to retain sodium and water, leading to elevated blood pressure. There are many causes of decreased blood flow to the kidneys. These include: [5] Atherosclerotic renal artery stenosis; Fibromuscular ...
A change in medication, however, is indicated if the decline in renal function is temporally related to therapy with an angiotensin (ACE) converting enzyme inhibitor or angiotensin II receptor blocker, which can interfere with renal autoregulation and produce acute kidney failure in patients with bilateral renal artery stenosis.
Hypertension, also known as high blood pressure, is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. [11] High blood pressure usually does not cause symptoms itself. [ 1 ]
The narrowing of the lumen can decrease renal blood flow and hence glomerular filtration rate leading to increased renin secretion and a perpetuating cycle with increasing blood pressure and decreasing kidney function. [12] The brain is another organ where hyaline arteriolosclerosis occurs prematurely in patients with high blood pressure.
CCT in adults is known to have high sensitivity, but a low specificity. [ 3 ] Subtraction angiography is considered a more suitable test for renal artery stenosis in adults.
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