Renal Hypertension-Symptoms, Causes, and Treatment
Renal hypertension or what is known as renovascular disease
It is elevated blood pressure as a result of kidney disease. It can be controlled by anti-hypertensive drugs or other means of medical help as angioplasty, stenting or blood vessels surgery of the kidney.
How is Renal Hypertension caused?
Renal hypertension is caused by a narrowing in the arteries that transmits blood to the kidney. Narrowing of the kidneys` arteries may be in one kidney or both. This condition is called renal artery stenosis.
When the amount of blood flow that reaches the kidney decreases, it acts as if the low flow is due to dehydration. So they respond by hormones release that stimulate retaining of sodium and water inside the body. By this retension, blood vessels are filled with additional fluid, and blood pressure rises up.
Atherosclerosis is usually the reason behinf narrowing the blood vessels which is the hardening of the arteries. This is the same process that causes heart attacks and strokes.
A less common cause of narrowing the arteries is fibromuscular dysplasia. It is the condition of abnormal renal arteries development for unclear reason.
Usually the narrowing of the arteries can not be felt, unless it`s of high dangerous level. High blood pressure causes no symptoms ,that is why it is called the silent killer. But the severely elevated blood pressure symptoms include:
The great majority of people with renal hypertension never experience any symptoms. This is why the high blood pressure is dangerous, partly because there are no symptoms, so organ damage can occur slowly without being noticed.
Renal hypertension can be the cause of chronic kidney disease. This is a gradual decrease in kidney function. Until the condition is greatly advanced, chronic kidney disease also causes no symptoms.
As there are usually no symptoms, the doctor may suspect renal hypertension when someone has uncontrolled blood pressure despite use of multiple kinds of medications or has unexplained chronic kidney disease.
Medications are used primarily to control high blood pressure in renal hypertension.
The most important blood pressure medications to treat renal hypertension include: three or more medications or the use of combined therapy as Blokatens®
In some patients with renal hypertension due to narrowing of the renal artery, even with taking three or more medications every day, this may be not adequate in controlling blood pressure. In these situations, your doctor may suggest another procedure to improve blood flow to the kidneys.
Possible procedures may include:
A doctor inserts a catheter through a large artery in the groin and then advances it into the renal artery. A balloon is then inflated which widens the artery and improves blood flow.
During angioplasty, stent (a wire-mesh) can be expanded inside the renal artery. The stent stays in certain place. This keeps the artery opened or dilated after the balloon is removed. Research, however, has not appeared that stenting is more effective than using medications for renal hypertension.
A surgeon can bypass the narrowed renal artery by a healthy blood vessel next to it by sewing. Surgery is considered only when angioplasty and stenting are not possible.
These procedures are similar to procedures used to improve blood flow in heart in patients with coronary artery disease.
For people whose blood pressure is not controlled even with multiple medications, surgery may be an effective fixation for renal hypertension.
If a procedure is needed, renal artery stenosis is usually treated by stenting or angioplasty. However, stenting/angioplasty has not been proved to be beneficial in most studies if compared to medical management alone. Still, it may have a role for treatment in some patients. Finally, procedures are more effective when only one kidney's artery is narrowed or affected rather than both.