Artery Problems of the Kidneys

Atherosclerosis of the arteries to the kidneys (i.e. "renal arteries") is suggested by hypertension and/or decreased efficiency of the kidneys as judged by blood testing (an elevated serum creatinine level indicates kidney dysfunction).
A patient suspected of having stenosis of one or both renal arteries will usually be sent for ultrasound examination.  If ultrasound examination confirms the clinical suspicion of renal artery stenosis, the patient may next be sent for conventional angiography.  Diagnosis of renal artery stenosis or occlusion is established by angiography. If treatment is required, the renal artery stenosis may be dilated using a balloon angioplasty catheter or a bypass may be performed to reroute blood around the lesion  blockage and into the kidney. 

Another condition which can cause stenosis of the renal arteries is called “Fibromuscular Dysplasia”. This condition typically affects women much more commonly than men and it usually affects younger women (age <45 years).  The typical presentation is that of fairly severe hypertension.  The evaluation is the same as described above for atherosclerotic stenosis of the renal arteries. The treatment is almost always with balloon angioplasty and stenting.  The results of therapy are good.  Fibromuscular dysplasia also can affect the carotid arteries and if a young woman is affected by fibromuscular dysplasia of the renal arteries, an ultrasound evaluation of the carotid arteries should also be undertaken.