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Renal Vascular Disease
A primary cause of kidney damage and failure
Overview
Renal Vascular Disease affects the blood flow in and out of the kidneys which may lead to high blood pressure and kidney damage or failure. There is the possibility of: Renal artery stenosis, which is the narrowing or blocking of an artery to the kidneys; Renal artery thrombosis, which is a blood clot in an artery that supplies blood to the kidney; Renal vein thrombosis, which is the formation of a clot in a vein to the kidney; Renal artery aneurysm, which is a bulging, weak area in the wall of an artery to the kidney; Or atheroembolic renal disease, which occurs when a piece of plaque from a larger artery breaks off and travels through the blood, blocking small renal arteries.
Symptoms
Symptoms of RVD vary wildly depending on the specific condition present and its degree of involvement. Many times, symptoms may not even be present, and if they are, they may look like other medical conditions or problems. However, some common symptoms include...
High Blood Pressure
Kidney Problems or Failure
Soreness, Tenderness, or Pain in the Flank, Belly, or Ribs
Blood present in the urine
Fever, nausea, vomiting, diarrhea, weight loss, confusion, or muscle aches
Skin lesions, red/purple color of the skin, or discolored areas of the toes and feet
Causes
The specific causes of RVD will vary depending on the specific condition involved, but some general causes are...
Personal History of Smoking, Obesity, High Blood Pressure, High Cholesterol, Atherosclerosis, or Diabetes
Certain medicines, Birth defects
Surgery, Tumor, or Aneurysm
Injury, Infection, Inflammation, or other underlying disease
Pregnancy, Older Age, Being Female
Diagnosis
To diagnose RVD, your vascular specialist will review your medical history and do a physical exam. They may also order certain diagnostic imaging tests. Arteriogram (or angiograms) are X-ray images of the blood vessels which are used to check for aneurysm, or the narrowing/blockage of your vessels. Duplex ultrasounds are done to check blood flow and the structure of the renal veins and arteries. Renography is used to check the function and structure of the kidneys. Magnetic resonance angiography (MRA) combines MRI and IV contrast dye to see blood vessels and locate blockages.
Treatment
Treatment varies greatly depending on the specific type of RVD you are suffering from. RAS, as well as ARD, may be treated with medicine to reduce blood pressure or cholesterol levels, or those to treat related conditions such as diabetes. RAS and ARD may also be treated surgically, either through open surgery to bypass the blocked renal artery or through endovascular procedures such as an angioplasty or the placement of a stent. RAT, in acute cases, will often utilize thrombolytic medicine injected into the renal artery for hours to days to bust the break up the clot. Surgery to remove the clot or bypass the artery may also be utilized. RAA treatment varies depending on the size and location of the aneurysm. Some cases may just require regular monitoring while others may require surgery. RVT is generally treated with an anticoagulant which keeps the blood from clotting.
Visit Society of Vascular Surgery for more information.
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