Renal Arterial Stenosis, Huh?

I recently attended a social function at which someone I respect tapped me on the shoulder and said, “Make sure you speak with our mutual friend before you leave.”  So I did … and was mystified when she conducted some small talk with me.  This is what he wanted me to hear?

Later I received a message from our mutual friend and all became clear.  She’d been diagnosed with renal arterial stenosis and her doctor wanted her to have surgery.  Could I help?  At that point, I couldn’t, but I could research for her and I did.

Then I got to thinking about how many of us with Chronic Kidney Disease don’t know what this is or what it might have to do with us, other than it starts with renal – which is from the Latin for kidneys. The Greek root is ‘neph’ as in nephrology.

I turned to What Is It and How Did I Get It? Early Stage Chronic Kidney Disease {Page 129} for the definition of arteries.

Vessels that carry blood from the heart.

Blood Oxygen Cycle Picture 400dpi jpgSo, we’re looking at vessels attached to the kidneys that bring in blood from the heart.  And why do we need that I wondered?  Oh wait.  I remember: the kidneys filter this blood and then send it back to your heart via the veins.

That’s where stenosis comes in.  According to the medical dictionary at http://medical-dictionary.thefreedictionary.com/stenosis, this is

a constriction or narrowing of a duct or passage; a stricture.

That same dictionary gave us a precise definition of renal artery stenosis.

narrowing of one or both renal arteries, so that renal function is impaired,

resulting in renal hypertension and, if stenosis is bilateral, chronic renal failure

So what we’re looking at here is a narrowing of the artery that brings blood from the heart to the kidneys for cleaning by the nephrons.

Now hold on there.  Let’s not panic, folks.  This does not mean automatic chronic renal failure and dialysis or transplant.

Let’s take a look at what might cause renal artery stenosis or RAS. I went directly to a trusted site, U.S. Department Of Health And Human Services, National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), A service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at http://kidney.niddk.nih.gov/kudiseases/pubs/RenalArteryStenosis/#cause.

About 90 percent of RAS is caused by atherosclerosis—clogging, narrowing, and hardening of the renal arteries. In these cases, RAS develops when plaque—a sticky substance made up of fat, cholesterol, calcium, and other material found in the blood—builds up on the inner wall of one or both renal arteries. Plaque buildup is what makes the artery wall hard and narrow.

Most other cases of RAS are caused by fibromuscular dysplasia (FMD)—the abnormal development or growth of cells on the renal artery walls—which can cause blood vessels to narrow. Rarely, RAS is caused by other conditions.

Our mutual friend had been making herself out to be a terrible person to herself, one who caused her own RAS.  Well, maybe she did… and maybe she didn’t. It could have been FMD or some other unknown condition.  If it wasn’t, I still can’t see her blaming herself if she didn’t know about preventing atherosclerosis.  The point is she does now and needs to deal with the RAS.

MedicineNet at http://www.medicinenet.com/renal_artery_stenosis/page2.htm#what_are_the_symptoms_of_renal_artery_stenosis tells us that symptoms aren’t that common.

In general, renal artery stenosis is not associated with any obvious or specific symptoms. Suspicious signs for renal artery stenosis include:

  • high blood pressure that responds poorly to treatment;
  • severe high blood pressure that develops prior to age 30 or greater than age 50;
  • an incidental finding (discovered through routine tests or tests performed for another condition) of one small kidney compared to a normal sized one on the other side.

Typically, unilateral (one-sided) renal artery stenosis may be related to high blood pressure whereas bilateral (two-sided) renal artery stenosis is more often related to diminished kidney function.

What about that surgery our mutual friend’s doctor wanted her to have? Is it really necessary?ras

Sometimes a regiment of several hypertension {High blood pressure} drugs, along with hyperlipidemia {High cholesterol} drugs, and perhaps aspirin can alleviate the problem. Then there’s angioplasty – a procedure in which a catheter is placed in the artery via a blood vessel, a balloon is then opened in the artery and stented to keep the renal artery open. Or, bypass surgery may be performed to avoid the blocked area of the renal artery.  Thank you to WebMD for this information which I paraphrased from http://www.webmd.com/hypertension-high-blood-pressure/guide/renal-artery-stenosis-symptoms-treatments?page=2.

My advice when surgery is suggested?  A second opinion.  Any doctor worth his salt will welcome this request and understand that it in no way casts aspersion on his/her value as a doctor. A second opinion from a nephrologist would be the way that I would go and I urged our mutual to seek one.

Here’s to our mutual friend and all of us who ever wondered what RAS is and what it has to do with CKD.

On another note entirely, here’s a bit of happiness I wanted to share with you.  These are reviews for What Is It and How Did I Get It? Early Stage Chronic Kidney Disease I hadn’t seen on Amazon.com… and all five stars!

One of the best on the subject not so much for the info but the way it was presented. Almost like a novel. Makes you forget your kidney is not behaving the way it should.

It is written for a patient like us, mean that the language it is simple and easy to understand, good sense of humor and a positive aptitude with this silent killer, another book that deserve a place on your personal library. Very informative , excellent book.

A book that is very helpful to CKD3 patients. It gives the facts and figures needed most to those with this condition!new blog shot

I’ve had this book in paperback for a while and when Amazon offered me the option to buy the digital version at a discounted price since I had purchased the paperback from them, I jumped at it. I’m a sucker for loaning out hard copy and this way if I find a fellow kidney disease sufferer, I can let them have my paperback and I will always have my digital backup for reference. This is a great book by a fellow kidney disease patient who also publishes a very good blog. There are so many details to track with this disease and she talks about the daily life of it. Very helpful and answers so many questions. She’s a born researcher, so all her information has backup links to let you know this is authentic medical advice to get some of those questions answered between doctor’s visits.

Until next week,

Keep living your life!

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  1. […] Renal Arterial Stenosis, Huh? […]

    • Thank you for the pingback Upper Endoscopy/ Find Me A Cure and everyone else who pingbacked the blog for the last four years. I so appreciate your helping to get this Chronic Kidney Disease information out to the public!


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