What Is Renal Vascular Disease ?
Renal vascular disease is the name given to a variety of complications that affect the arteries and veins of the kidneys. These complications affect the blood circulation of the kidneys, and may cause damage to the tissues of the kidneys, kidney failure, and/or high blood pressure.
Vascular conditions affecting the renal arteries and veins include the following:
- Renal Artery Stenosis :
Renal artery stenosis is a blockage of an artery to the kidneys. It may cause kidney failure and hypertension (high blood pressure).
- Renal Artery Thrombosis :
Renal artery thrombosis is the formation of a clot in a renal artery. A thrombosis of a renal artery may cause kidney failure because of blocked blood flow to the kidney.
- Renal Artery Aneurysm :
A renal artery aneurysm is a bulging, weakened area in the wall of an artery to the kidney. Most of these aneurysms are small (less than two centimeters, or about three-quarters of an inch) and without symptoms. Renal artery aneurysms are uncommon, and are generally discovered during diagnostic procedures performed in relation to other conditions.
- Atheroembolic Renal Disease :
Atheroembolic renal disease occurs when a piece of plaque from the aorta and/or other large arteries breaks off and travels through the bloodstream, blocking small arteries such as the renal arteries. Atheroembolic renal disease is becoming a common cause of renal insufficiency (poor kidney function) in the elderly.
- Renal Vein Thrombosis :
A renal vein thrombosis is the formation of a clot in a vein to the kidney.
The renal arteries arise from the aorta at the level of the intervertebral disc between the L1 and L2 vertebrae. Cadaveric studies have shown that more than one renal artery is present in 15% and 20% of cases on the right and left sides, respectively. A great deal of variety can be found in the anatomy of the renal artery and its branches, but most often the main renal artery splits into an anterior and posterior division. Within the hilum, the anterior division gives rise to apical, anterior, and inferior segmental branches, as depicted in the image below. Segmental vessels then penetrating the renal parenchyma becoming lobar, interlobar, arcuate, interlobular arteries, afferent arterioles, then finally reach the capillaries and glomeruli
Risk factors for renal vascular disease include:
- Female gender
- Hypertension, particularly new onset of hypertension in an older person
- High cholesterol
A risk factor is anything that may increase a person's chance of developing a disease. It may be an activity, such as smoking, diet, family history, or many other things. Different diseases have different risk factors.
How Is Renal Vascular Disease Diagnosed ?
In addition to a complete medical history and physical examination, diagnostic procedures for renal vascular disease may include any, or a combination of,
- Arteriogram (Also called an angiogram.) - an x-ray image of the blood vessels used to evaluate various conditions, such as aneurysm, stenosis (narrowing of the blood vessel), or blockages. A dye (contrast) will be injected through a thin flexible tube placed in an artery. This dye makes the blood vessels visible on x-ray.
- Duplex ultrasound - a type of vascular ultrasound procedure done to assess blood flow and the structure of the leg veins. The term "duplex" refers to the fact that two modes of ultrasound are used - Doppler and B-mode. The B-mode transducer (like a microphone) obtains an image of the carotid artery being studied. The Doppler probe within the transducer evaluates the velocity and direction of blood flow in the vessel.
- Renography - a specialized radiology procedure used to assess the function and structure of the kidneys. Renography is a type of nuclear radiology procedure. This means that a tiny amount of a radioactive substance is used during the procedure to assist in the examination of the kidneys.
Treatment For Renal Vascular Disease
Specific treatment will be determined by your physician based on:
- Your age, overall health and medical history
- Extent of the disease
- Your signs and symptoms
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
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