17422 Renal Artery Disease

Overview

Renal artery disease is a condition where the arteries that carry blood to your kidneys become narrow or blocked. This can reduce blood flow to the kidneys, making it harder for them to work properly. It can also cause high blood pressure or make existing high blood pressure worse.

Renal artery disease is not as common as other heart or blood vessel conditions, but it becomes more likely as people get older. It is most often seen in people over 50, especially those with a history of atherosclerosis.

It mainly affects older adults who have hardening of the arteries (atherosclerosis). People with high blood pressure, diabetes, high cholesterol, and those who smoke are at greater risk. In younger people, especially women, a condition called fibromuscular dysplasia can also cause renal artery narrowing.

Symptoms

Common symptoms

• Most people have no symptoms at first.
• High blood pressure that is difficult to control with treatment.
• Swelling in the legs, ankles, or feet due to fluid buildup.
• Fatigue or feeling unusually tired.
• Changes in urination, such as producing less urine or needing to urinate more often at night.

Symptoms in children

• Renal artery disease is rare in children, but when it happens, it may cause high blood pressure.
• Children may have poor growth, fatigue, or headaches.
• A doctor may find the problem during a check-up for high blood pressure.

Symptoms in older adults

• Older adults may notice increased fatigue, swelling in the feet or hands, and shortness of breath.
• High blood pressure may become harder to control, even with several medications.
• Kidney function tests may show a gradual decline.

Causes

Main causes

• Atherosclerosis: A buildup of cholesterol, fat, and other substances (called plaque) on the inside of the artery walls. This is the most common cause.
• Fibromuscular dysplasia: A condition where the artery wall becomes abnormally thick or stretchy, often in younger women.
• Inflammation of the blood vessels (vasculitis) or injury to the kidney arteries can also cause narrowing.

Risk factors

• Age, especially being over 50
• Smoking or using tobacco
• High blood pressure
• High cholesterol
• Diabetes
• Kidney disease
• A family history of heart, artery, or kidney disease

When to see a doctor

See a doctor urgently if:

• You have very high blood pressure that causes headaches, dizziness, or nosebleeds.
• You suddenly produce very little urine or stop urinating.
• You notice new or worsening swelling in your legs, feet, or face.

Book a routine appointment if:

• You have high blood pressure, diabetes, or high cholesterol and are worried about your kidneys.
• You feel unusually tired, have swollen feet, or have changes in how often you urinate.
• Your doctor has told you that your kidney function tests are not normal.

Diagnosis

A doctor will first review your medical history, measure your blood pressure, and listen to your abdomen and back for a whooshing sound (called a bruit) that may indicate narrowed arteries. They will also order blood and urine tests to check how well your kidneys are working.

Tests that may be done

• Blood pressure readings taken on several occasions
• Blood tests to check creatinine and estimated glomerular filtration rate (eGFR) for kidney function
• Urine tests to look for protein or blood
• An ultrasound of the kidneys (renal ultrasound) to look at blood flow
• A CT scan or MRI (magnetic resonance imaging) to get detailed pictures of the kidney arteries
• A renal angiogram, where dye is injected into the arteries to see blockages (sometimes done before treatment)

What to expect at your appointment

The diagnostic process is usually painless and done as an outpatient. You may need to fast before a CT or MRI or before blood tests, and your doctor will give you specific instructions. After the tests, your doctor will explain the results and discuss what they mean for your health.

Treatment

The main goals are to control blood pressure, protect your kidney function, and reduce your risk of heart attack and stroke. Treatment usually begins with lifestyle changes and medications. If the narrowing is severe or not controlled by medicine, a procedure to open the artery may be considered.

Self-care at home

• Quit smoking and avoid secondhand smoke.
• Take all prescribed medicines exactly as directed, even if you feel fine.
• Monitor your blood pressure at home and keep a record for your doctor.
• Learn to manage stress with relaxation techniques, hobbies, or meditation.
• Avoid over-the-counter anti-inflammatory pain relievers, as they can harm the kidneys if used long term. Ask your pharmacist or doctor first.

Medical treatments

Doctors often prescribe medications to lower blood pressure and reduce cholesterol. Some of these medicines also help protect your kidneys. The choice and dose of medication depend on your kidney function, blood pressure level, and other health conditions. Never stop or change medications without talking to your doctor.

When is surgery considered?

If a severe narrowing is causing uncontrolled high blood pressure or declining kidney function, a procedure called angioplasty may be recommended. In angioplasty, a doctor inserts a thin tube with a small balloon into the artery to widen it, often leaving a stent (a small mesh tube) to keep it open. In rare cases, open surgery to bypass the narrowed artery is needed.

Living with this condition

Living with renal artery disease means being mindful of your blood pressure and kidney health. You will likely have regular appointments with your doctor to check your blood pressure and kidney function. Keeping a healthy routine and following your care plan can help you feel in control.

Lifestyle tips

• Quit smoking — this is one of the most important steps you can take.
• Stay physically active, but check with your doctor about safe activities like walking, swimming, or cycling.
• Maintain a healthy weight to reduce strain on your heart and kidneys.
• Get enough sleep and take steps to manage stress.
• Limit alcohol intake and check with your doctor about safe limits for you.

Diet and exercise

A heart-healthy diet is good for your kidneys too. Eat plenty of fruits, vegetables, whole grains, and lean proteins like fish or chicken. Limit salt, processed foods, and sugary drinks. Regular exercise like brisk walking for 30 minutes most days can help lower blood pressure, but it is important to discuss your exercise plan with your doctor if you have any restrictions.

Mental health and emotional wellbeing

Living with a chronic condition like renal artery disease can cause worry, anxiety, or low mood. These feelings are normal. Talk openly with your doctor or a counselor if you are struggling, and do not be afraid to ask for help.

Prevention

You cannot always prevent renal artery disease, but you can greatly reduce your risk by controlling blood pressure, cholesterol, and diabetes. Adopting a heart-healthy lifestyle, staying active, and not smoking are powerful steps.

Vaccines

Keeping your vaccinations up to date is important, especially for flu and COVID-19, because people with kidney problems are at higher risk of complications from infections. Ask your doctor or pharmacist which vaccines are recommended for you.

Screening programmes

There is no routine screening for renal artery disease in the general population. However, if you have risk factors like high blood pressure or diabetes, your doctor will likely check your blood pressure and kidney function regularly. Early detection of risk factors is the best way to protect your kidneys.

Complications

If left untreated

• Chronic kidney disease and gradual loss of kidney function
• Kidney failure, sometimes requiring dialysis or a kidney transplant
• Heart attack or stroke due to underlying blood vessel damage
• Fluid buildup that can cause shortness of breath and swelling
• Sudden blockage of a kidney artery (renal artery occlusion), leading to severe kidney damage

Long-term outlook

With early detection and good control of blood pressure, most people with renal artery disease can protect their kidneys and live full, active lives. Treatments are continually improving, and your doctor can help you find the best approach. While the condition needs ongoing care, many people manage it well and avoid serious problems.

Find support

Local organisations

• Your general practice (NHS) or local health center · UK

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.