Stenosis of the renal arteries

Stenosis of the renal arteries is due to fibromuscular or atherosclerotic changes in the renal artery, which lead to a narrowing of the vessel with a decrease in renal blood flow. As a result, a renin-angiotensin-aldosterone mechanism is activated that causes renal hypertension. Symptoms: high blood pressure, especially diastolic. For fibromuscular hyperplasia is characterized by a young age, a sudden appearance of hypertension with severe pain in the lateral parts of the abdomen. In 30-50% of cases, stenotic murmur over the renal vessels is determined. With intravenous urography, there is a decrease in the size of the kidney, a slowdown in the release of contrast media, and with radionuclide scanning, a decrease in blood flow in the renal parenchyma and vein. With aortography and selective renal angiography determine the type, location and degree of narrowing of the vessel.

Indications for surgery: proven arterial stenosis, juvenile hypertension and increased plasma renin activity in the affected kidney. Possible options for surgical treatment: balloon vasodilation of the stenotic artery, endarterectomy, resection of the stenotic portion of the vessel, implantation of the renal artery to a new aortic site, resection of the vessel with prosthesis by autovenous or allograft, bypass shunting.

Prognosis: with fibromuscular stenosis of the renal artery, the normalization of pressure can be achieved in 80-90%, with atherosclerosis and arteritis -40-50%