July 25, 2014
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Renovascular Disease



The Facts on Renovascular Disease

Renovascular disease is a progressive condition that causes narrowing or blockage of the renal arteries or veins. These are the blood vessels that take blood to and from the kidneys. It's the general term used for three disorders: renal artery occlusion, renal vein thrombosis, and renal atheroembolism.

The term is most often used to describe diseases affecting the renal arteries since blockage of the renal vein is not very common. Renovascular disease usually affects the elderly. However, young women in their teens to late 30s are at risk of a certain type of renovascular disease called fibromuscular dysplasia, a disorder of the muscular lining of the renal arteries that can cause severe high blood pressure.

Renal artery occlusion happens when one or both of the renal arteries are blocked. The arteries carry blood to the kidneys, where waste material is filtered out of the blood.

Renal vein thrombosis occurs when the veins leaving the kidneys (the renal veins) become blocked. The renal veins carry the filtered blood away from the kidneys to the rest of the body.

Renal atheroembolism results from a buildup of fatty material that blocks the renal arterioles (the smallest section of blood vessels leading to the capillaries). Cholesterol and lipids (fats) may also build up on the lining of the blood vessels, causing them to narrow.

Causes of Renovascular Disease

People who are at risk for other vascular diseases (blood vessel problems) are also more likely to develop renovascular disease (e.g., seniors). For some people on high blood pressure medications, such as ACE (angiotensin-converting enzyme) inhibitors, the problem may be discovered if side effects such as kidney failure or other severe kidney problems appear. As well, smokers and people with diabetes seem to be more likely to develop renovascular disease, as are people with high blood pressure.

Renal artery occlusion occurs when the renal arteries become closed off, either partially or totally, by an embolism (a blood clot or foreign substance that blocks a blood vessel) or hardening of the arteries. Hardening of the arteries occurs when cholesterol, calcium, and other substances line the arteries. Embolisms can be caused by heart disease, surgery, trauma, or tumours.

Renal vein thrombosis is fairly uncommon, but if there's been a trauma to the back or abdomen, a blood clot may form and get stuck in the renal veins. Sometimes it's a result of other kidney-related conditions (e.g., nephrotic syndrome, kidney cancer). Occasionally, a test or procedure might also trigger an embolism.

Children can also develop renal vein thrombosis, though rarely. Renal vein thrombosis in children under one year old is usually caused by reduced blood flow to the kidneys, severe dehydration, and infants with a condition that forms excessive clots (hypercoagulopathy).

Renal atheroembolism is caused by atherosclerosis. Risk factors for developing atheroembolism include:

  • diabetes
  • family history of the condition
  • heart disease
  • high blood pressure
  • high cholesterol
  • obesity
  • smoking




Symptoms and Complications of Renovascular Disease

There aren't usually any warning signs of renovascular disease, but as the disorder gets worse, high blood pressure and symptoms related to kidney failure may appear. Symptoms of kidney failure may include:

  • bad taste in the mouth
  • chest pain
  • confusion or anxiety
  • fatigue
  • itchy skin
  • loss of appetite
  • muscle twitching or cramping
  • nausea and vomiting
  • pale or yellowish-brown tinted skin
  • puffy eyes, hands, and feet
  • weight loss

As the kidney failure gets worse and the toxins continue to build up in the body, seizures and mental confusion can occur.

In renal artery occlusion and renal vein thrombosis, there may be no symptoms if only one kidney is blocked, because the other kidney is usually able to handle the work of two. If both kidneys are partially affected, or if one is totally affected and the other is partially affected and the blockages have occurred quickly, the following symptoms may appear:

  • back or side pain
  • blood in the urine
  • fever
  • nausea and vomiting
  • no urine (if there's a total blockage)

In renal atheroembolism, there's a chance that there are embolisms in other parts of the body as well, including the retina in the eye, which in very rare cases may affect vision.

The complications of renovascular disease are serious. As a result of the high blood pressure the condition causes, some of the following complications may occur:

  • blood vessel damage
  • congestive heart failure
  • heart attack
  • kidney damage or failure
  • loss of vision
  • stroke

Renal vein thrombosis has an added complication: blood clots can move from the kidneys to the lungs, causing a pulmonary embolism.

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