Renal hypertension, which health experts more commonly refer to as renovascular hypertension, is a type of high blood pressure that starts in the kidneys. It occurs due to a blockage in the arteries that carry blood to the kidneys.
This article discusses what renovascular hypertension is. It also examines how high blood pressure affects the kidneys, and outlines the causes, symptoms, and treatment options for the condition.
Renovascular hypertension is one of the most common causes of secondary hypertension, which is high blood pressure that stems from a different medical condition. Moreover, it can lead to high blood pressure that is resistant to treatment.
What is high blood pressure, and how does it affect the kidneys?
Over time, blood pressure can damage and weaken blood vessels throughout the body, including those in the kidneys. When the blood vessels in the kidneys become damaged, it can affect how well the kidneys function.
When the kidneys do not function properly, it can lead to excess fluid and waste buildup in the bloodstream. This in turn can cause high blood pressure, resulting in further damage to the kidneys.
Over time, a person can develop kidney failure.
Similarly, early stages of kidney disease or damage may not cause any symptoms. However, as kidney damage progresses, a person may develop edema. This is swelling that can occur in various parts of the body, including the feet and hands.
If kidney disease progresses to an advanced stage, an individual may develop symptoms such as:
- muscle cramps
- unexplained weight loss
- chest pain or shortness of breath
- sleep problems, drowsiness, or tiredness
- nausea, vomiting, or loss of appetite
- trouble concentrating
- changes in urine volume
- generalized numbness or itchiness or darkened or dry skin
If a person is taking multiple medications to manage their blood pressure, and these are not having an effect, doctors may suspect that renovascular hypertension could be the cause.
Any condition that affects blood flow to the kidneys can lead to renovascular hypertension.
Other potential causes
- inflammation of the arteries that can be due to the following conditions:
- Takayasu’s arteritis
- antiphospholipid antibody syndrome
- middle aortic syndrome
- radiation fibrosis, which is a side effect of radiation therapy
- compression of the renal arteries
- renal artery dissection, which can occur after injury to the blood vessel
- obstruction resulting from surgery on the arteries
Is it hereditary?
Diet can play a role in helping increase or decrease a person’s risk of developing renovascular hypertension.
The National Kidney Foundation recommends a person follow Dietary Approaches to Stop Hypertension, or the DASH diet, to help improve their hypertension.
The DASH diet recommends foods such as:
It also limits or eliminates the consumption of:
The main goal of treatment for renovascular hypertension is to lower blood pressure. Lowering blood pressure can help prevent kidney damage and have a positive effect on other aspects of health.
Individuals with renovascular hypertension will typically require multiple medications to treat the condition.
In addition to these, a doctor may prescribe other medication to help with either the kidneys or high blood pressure. One type of medication a healthcare professional may prescribe is diuretics, which help the kidneys process and remove more fluid.
To directly treat renal artery disease, a doctor may recommend undergoing one of
Angioplasty involves using a balloon inserted through the groin to help widen the arteries in the kidneys that have closed or narrowed.
Renal bypass surgery involves placing stents to bypass the blocked arteries.
Both are low-risk procedures, and a person can have either of them as an outpatient or inpatient. An inpatient surgery will require an individual to spend a single night in the hospital.
Medicines vs. surgery
Medications and lifestyle changes are generally the first line of treatment. Recent research does not suggest that surgery is more beneficial than medications.
Doctors may also consider surgery if a person is experiencing:
In addition to medications and possible procedures, there are some steps a person can take to help prevent or reduce their high blood pressure.
Some potential changes a person can make
- achieving or maintaining a moderate body weight
- engaging in physical activity more
- following a healthy, low sodium diet
- quitting smoking
- taking steps to manage stress
Early diagnosis can make a difference in controlling blood pressure and preventing damage to the kidneys.
To diagnose high blood pressure, a healthcare professional will use a pressure cuff to measure a person’s blood pressure. They may diagnose high blood pressure if the blood pressure reading is above 130/80.
To help diagnose kidney disease, a healthcare professional may perform a blood test to check the function of the kidneys. They may also order urine tests to check for albumin, which is a protein present in the urine as a result of damage to the kidneys.
A doctor can use imaging tests to help determine whether a person’s renal arteries have become affected.
Tests they may use to help diagnose renovascular hypertension
- duplex ultrasound
- CT angiography
- MR angiography
Renovascular hypertension can lead to several serious complications,
- heart attack
- heart failure
- left ventricular hypertrophy, which is the thickening of the left pumping chamber of the heart
- pulmonary edema, which is excess fluid in the lungs
- retinopathy, which is a condition that affects the retina
- vascular dementia, which is a type of dementia that results from reduced blood flow to the brain
High blood pressure, regardless of the cause, can lead to kidney disease or failure. The
When the kidneys start to work less effectively, it can cause higher blood pressure, which, over time, can damage the kidneys and lead to their eventual failure.
If a person receives a renovascular hypertension diagnosis, it is important that they follow the doctor’s treatment recommendations. This can include making changes to their diet, as well as getting more exercise and taking medications as prescribed. This can help slow the progression of kidney disease.
When left untreated or not sufficiently treated, the condition
A large part of treatment of renovascular hypertension is preventing damage or more damage to the kidneys from occurring.
An individual can change their lifestyle to help prevent high blood pressure. Some steps to try
Renovascular hypertension may not cause symptoms. A doctor may discover a person has high blood pressure during a routine examination.
A person living with high blood pressure who notices their numbers increasing should consult a doctor.
Moreover, individuals living with renovascular hypertension should let a doctor know if they experience any new or worsening symptoms.
Renovascular hypertension occurs when arteries in the kidneys become blocked or narrowed, causing high blood pressure to occur.
Without treatment, high blood pressure can lead to several complications, including kidney failure.
Treatment typically involves the use of blood pressure-lowering medications, diuretics, and lifestyle changes, such as getting more exercise and following a balanced diet.