Renal Vascular Disease

What is renal vascular disease?

Renal vascular disease affects the blood flow into and out of the kidneys. It may cause kidney damage, kidney failure, and high blood pressure.

Types of renal vascular disease
are:

  • Renal artery stenosis (RAS). This is a narrowing or
    blockage of an artery to the kidneys. It may cause kidney failure and high blood
    pressure. Smokers have a greater risk of getting RAS. High cholesterol, high
    triglycerides, diabetes, too much weight, and a family history of heart disease are
    also risk factors for RAS. High blood pressure is both a cause and a result of
    RAS.
  • Renal artery thrombosis. This is a blood clot in an artery that supplies a kidney. It may
    block blood flow and cause kidney failure.
  • Renal vein thrombosis. This is the formation of a clot in
    a vein to a kidney.
  • Renal artery aneurysm. This is a bulging, weak area in the
    wall of an artery to a kidney. Most are small and don’t cause symptoms. Renal artery
    aneurysms are rare and are often found during tests for other conditions.
  • Atheroembolic renal disease. This happens when a piece of
    plaque from a larger artery breaks off and travels through the blood. This blocks
    small renal arteries. This disease is becoming a common cause of kidney problems in
    older adults.

Renin is a strong hormone that
raises blood pressure. Decreased blood flow to a kidney from renal vascular disease may
cause too much renin to be made. This can lead to high blood pressure.

What causes renal vascular disease?

The cause of renal vascular disease will depend on the specific condition involved. The main causes are:

  • Atherosclerosis
  • Diabetes
  • Hypertension
  • Morbid obesity
  • Fibromuscular dysplasia
  • Injury
  • Infection
  • Inflammatory or other underlying
    disease
  • Surgery
  • Tumor
  • Aneurysm
  • Pregnancy
  • Certain medicines
  • Birth defect

Who is at risk for renal vascular disease?

Risk factors for renal vascular disease include:

  • Older age
  • Female sex
  • Atherosclerosis
  • High blood pressure, especially new high blood pressure in an older person
  • Smoking
  • High cholesterol
  • Diabetes

What are the symptoms of renal vascular disease?

Symptoms of renal vascular disease vary depending on the type of disease and degree of involvement present.

Type of renal vascular disease

Symptoms

Renal artery stenosis

  • High blood pressure
    that doesn’t get better with 3 or more medicines
  • Increased urea (a waste
    product made by the kidneys) in the blood
  • Unexplained kidney
    failure
  • Sudden kidney failure
    when first taking an angiotensin-converting enzyme (ACE) inhibitor to
    treat high blood pressure or heart conditions      

Renal artery thrombosis

  • Sudden onset of side
    pain between the ribs and the upper border of the hip bone (flank
    pain), pain, and tenderness
  • Fever
  • Blood in the urine
  • Nausea and vomiting
  • Sudden decrease in kidney function
  • High blood pressure

A gradual or
incomplete clot may not cause symptoms and go undetected.

Renal artery aneurysm

  • Often no
    symptoms     
  • High blood pressure
  • Flank pain and blood in
    the urine if a tear in the aneurysm

Atheroembolic renal disease

  • Skin lesions or red or
    purple color of the skin
  • Discolored areas of the
    toes and feet
  • Kidney failure
  • Belly pain
  • Diarrhea
  • Nausea, vomiting
  • Confusion
  • Weight loss
  • Fever
  • Muscle aches

       

Renal vein thrombosis

Slow onset:

  • Most often no
    symptoms

Sudden onset:

  • On-going severe flank pain with spasms at times
  • Soreness over the kidney, between the ribs and the backbone
  • Decreased kidney function
  • Blood in urine    

These symptoms may look like other
health problems. Always talk with your healthcare provider for a diagnosis.

How is renal vascular disease diagnosed?

Your healthcare provider will
review your medical history and do a physical exam. You may also need these tests:

  • Arteriogram (or angiogram). This is an X-ray image of the
    blood vessels used to check for aneurysm, narrowing, or blockages. A dye (contrast)
    is injected through a thin, flexible tube placed in an artery. This dye makes the
    blood vessels visible on X-ray.
  • Duplex ultrasound. This test is done to check blood flow
    and the structure of the renal veins and arteries. The term “duplex” refers to the
    fact that 2 modes of ultrasound are used. The first takes an image of the renal
    artery being studied. The second mode checks the blood flow.
  • Renography. This test is used to check the function and
    structure of the kidneys. It is a type of nuclear medicine procedure. This means that
    a tiny amount of a radioactive substance is used during the test to help view the
    kidneys.
  • Magnetic resonance angiography (MRA). This test uses a
    combination of magnetic fields and radio waves along with intravenous (IV) contrast
    dye to see blood vessels. Contrast dye causes blood vessels to appear solid on the
    MRI image. This lets the healthcare provider see the blood vessels and how the blood
    flows through them.