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Treating renal artery stenosis: How to give critical organs a fighting chance

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Omar P. Haqqani, MD
Midland Daily News
January 8, 2017

The kidneys are among the most essential organs in the human body due to their important role in regulating many aspects of our circulatory and urinary systems. However, many of these regulations can be affected by renal artery stenosis – the blocking and narrowing of the kidney’s vascular connection.

The kidneys, despite being roughly the size of a clenched fist, have a lot of responsibilities to tend to – many of which are important for the body function properly.

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Without this pair of bean-shaped organs, the body wouldn’t have a vital outlet for regulatory roles, such as blood filtration, urea and ammonium excretion and reabsorption of amino acids, glucose and water.

One of the many ways that the kidneys aren’t able to perform these functions is due to renal artery stenosis – a condition that occurs when plaque build-up affects the flow of oxygenated blood from the aorta to the organs.

If proper blood flow isn’t achieved, injury to the tissues or hypertension could occur, not allowing for blood to filter efficiently. Furthermore, if the blockage isn’t properly assessed, more severe medical problems, such as stroke, aneurysms, aortic or cardiac issues, could occur.

Factors that can increase a person’s risk for developing renal artery stenosis include, but are not limited to: Atherosclerosis, fibromuscular dysplasia, inflammatory diseases, diabetes, tumors, aneurysms, high cholesterol, smoking, heart disease, and obesity.

Additionally, though the risk factors and effects of renal artery stenosis are synonymous between both genders, the condition more commonly affects women.

Renal artery stenosis is most commonly diagnosed through a multitude of processes. Duplex ultrasound checks the structure of renal arteries and veins, as well as the blood flow received through them, while diagnostic angiogram involves the insertion of a thin, flexible tube into the artery and injection of x-ray imaging dye to note areas of blockage.

Specialized imaging can also be a helpful method of diagnosing renal artery stenosis. With this method, the function and structure of the kidneys are tested by the use of a small amount of a radioactive substance.

To those who are diagnosed with renal artery stenosis, fear not: Though its effects may seem daunting, there are many methods of treatment for this condition.

In many earlier cases of the condition, as well as a helpful method of prevention, adopting simple lifestyle changes can be very helpful.

All patients are advised to maintain a healthy diet and body weight, as well as to implement a 30-minute exercise regimen three days a week. Furthermore, patients who smoke are highly advised to quit.

In cases of noticeable blockage, medication is prescribed alongside the previously discussed lifestyle changes to help control risk factors.

Some medications help to relax blood vessels or establish a more relaxed heartbeat, such as beta blockers, ACE inhibitors and Calcium channel blockers, while other drugs control cholesterol levels or eliminate excess water from the body, such as statin drugs or diuretics.

It is important to remember, however, that medications should not be taken until a medical doctor or vascular specialist has given proper diagnosis.

In severe cases of renal artery stenosis, where lifestyle changes and medications are not enough to take care of the condition, minimally invasive surgery can be done, depending on the overall health of the patient, as well as the extent and location of the blockage.

Angioplasty and stenting are procedures done by placing a catheter into a small puncture over an artery in the arm or groin, and directed towards the blockage under x-ray guidance. A small balloon is inflated and deflated several times, pushing and compressing the plaque to the walls of the artery, which helps allow blood to flow freely.

Bypass surgery can also be utilized. A graft, or a synthetic, round tube, is inserted into a vein, where the blood flow is rerouted to a different artery, restoring the correct amount of blood to the affected tissues. Additionally, renal artery endarterectomy can help to remove the build-up of fats, cholesterol, and the total summation of plaque from the renal arteries.

Because the kidneys are among the most essential of organs found in the human body, a condition like renal artery stenosis can severely impact the way their processes take place.

Thanks to modern advancements in diagnosis and treatment, however, renal artery stenosis doesn’t have to have a place in your vascular lifestyle.

Dr. Omar P. Haqqani is the chief of Vascular and Endovascular Surgery at Vascular Health Clinics in Midland.

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