Renal Artery Stenosis

  • Medical Author:
    Siamak N. Nabili, MD, MPH

    Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What are the causes of renal artery stenosis?

The majority of renal artery stenosis is caused by atherosclerosis (hardening and narrowing of blood vessel wall from the inside) similar to the process that occurs in blood vessels in the heart and other parts of the body.

Risk factors for atherosclerosis include:

Less common causes of renal artery stenosis are rare conditions such as fibromuscular dysplasia of the vessels (narrowing of the vessel due to internal thickening of the blood vessel wall), arteritis (inflammation of the blood vessel), or dissection (tearing and division of the blood vessel wall).

How common is renal artery stenosis?

Narrowing of the kidney arteries is more common in individuals 50 years of age and older. It is estimated that some degree of narrowing (greater than 50%) is found in about 18% of adults between 65-75 years of age and 42% of those older than 75 years of age. This may be due to the fact that atherosclerosis is more common in this age group.

In younger patients, the narrowing of the renal artery usually is due to the thickening of the artery (fibromuscular dysplasia) and it is more common in women than men.

It is estimated that renal artery stenosis accounts for approximately 1% of mild to moderate cases of high blood pressure. It may be responsible for more than 10% of cases of severely elevated or difficult to treat high blood pressure (hypertension).

What are the symptoms of renal artery stenosis?

In general, renal artery stenosis is not associated with any obvious or specific symptoms. Suspicious signs for renal artery stenosis include:

  • high blood pressure that responds poorly to treatment;
  • severe high blood pressure that develops prior to age 30 or greater than age 50;
  • an incidental finding (discovered through routine tests or tests performed for another condition) of one small kidney compared to a normal sized one on the other side.

Typically, unilateral (one-sided) renal artery stenosis may be related to high blood pressure whereas bilateral (two-sided) renal artery stenosis is more often related to diminished kidney function.

Medically Reviewed by a Doctor on 6/4/2015

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