Renal Artery Hypertension

Renal Hypertension–A Major Cause of End-stage Renal Disease

Renal hypertension puts stress and increased pressure on the kidney, and is a major cause of end-stage renal disease, also known as chronic renal disease, in the elderly. Vascular disease, also known as atherosclerosis, is prevalent in the United States, and as the population ages, the number of people with vascular disease will increase. So too will the number with renovascular hypertension and end-stage renal disease. People with end-stage renal disease require dialysis or kidney transplantation.

Renovascular hypertension should be suspected when the onset of hypertension occurs before age 30 or after age 50, or when stable hypertension becomes more difficult to control with medication. White males and blacks of both sexes are at higher risk and people over 50 are at higher risk

Complications of Renovascular Hypertension

• Early death
• Hypertensive heart disease
• Myocardial infarction  (heart attack)
• Congestive heart failure
• Renal insufficiency or failure
• Stroke
• Retinopathy, i.e., damage to the eyes from high blood pressure

Diagnosis and Treatment

With imaging studies and biochemical work-up,  your doctor can accurately diagnose renovascular disease. If medical management-medications and lifestyle changes-are insufficient, interventional radiologists can perform angioplasty and, if needed, stenting, to improve blood flow to the kidney. The goal of the treatment in renovascular disease is normalization of the blood pressure or improvement of its control with medications, and improvement or preservation of kidney function. Angioplasty of the renal artery is relatively low risk and can greatly improve blood pressure control and thus prevent further damage to the kidney. Balloon angioplasty and stenting has generally replaced surgery as the first-line treatment for renal arterial occlusions.   Most of these treatments are performed as an outpatient or with one night stay in the hospital with only a small skin incision in the groin.

New Treatment for Uncontrolled Hypertension Investigated by Interventional Radiology at TGH

A new, novel treatment for uncontrolled hypertension is being evaluated at TGH under a randomized multi-center national study.  The study is intended for patients with elevated blood pressure already on several blood pressure medications.  As the procedure is being performed in Europe and South America, but is not approved by the FDA, it can only be performed as part of the study in the US.  The procedure involves a tiny catheter being placed in the renal (kidney) artery for several minutes.  All of the medical tests and follow-up are provided free-of-charge to the patients.  Only half of the patients in the study will initially receive the treatment, however, those patients who continue to have high blood pressure at the end of the study will be offered the treatment if they did not receive it.  If you have poorly controlled hypertension and/or are on several blood pressure medications consider calling our office for an appointment to learn more about this new, exciting treatment!