What is renal artery stenosis?

Also called renovascular disease, RAS is a narrowing or blockage (atherosclerosis) in the renal artery (the main artery leading into the kidneys). As less blood flows to the kidneys, blood vessels throughout the body are constricted. This, in turn, causes blood pressure to rise. RAS is a main cause of hypertension (high blood pressure) for between 3 and 8 percent of the 10-25% of people in the U.S. who have hypertension.

Is RAS serious?

Yes. Because it puts so much stress and increased pressure on the kidneys, renal hypertension is a major cause of end stage renal disease. Ultimately, RAS can cause eye damage (because of the high blood pressure), renal insufficiency or failure, stroke, heart failure, and early death.

Who is at risk for renal artery stenosis?

Anyone with atherosclerosis or hardening of the arteries is at risk, especially after the age of 70. You have an increased risk if you:

• smoke or did smoke
• have diabetes
• have high blood pressure

How is RAS detected?

RAS can be difficult to detect because the systemic blood pressure may remain normal even while the renal blood vessels are experiencing hypertension. Because this disease significantly affects the elderly, non-invasive methods of diagnosis are particularly important. Depending on physician and patient needs, the interventional radiologist may choose from a number of non-invasive diagnostic tools including: biochemical work-up, radionuclide scanning, duplex ultrasound, magnetic resonance angiography, computed tomography, and arteriography.

Does the interventional radiologist treat renal artery stenosis?

Yes. The goal in treatment is to normalize blood pressure and improve or preserve kidney function. Minimally invasive angiography and stenting is usually recommended in cases for which medication is unsuccessful and the artery is significantly narrowed (see angiography and stenting).