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Medical Author:

Siamak T. Nabili, MD, MPH

Siamak T. 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.

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Medical Editor:

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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In this Article

• What are the renal arteries?
• What is renal artery stenosis?
• What are the causes of renal artery stenosis?
• How common is renal artery stenosis?
• What are the symptoms of renal artery stenosis?
• What problems does renal artery stenosis cause?
• Who should be screened for renal artery stenosis?
• How is renal artery stenosis diagnosed?
• What are the common imaging tests to evaluate renal artery stenosis?
• What functional tests are used for the diagnosis of renal artery stenosis?
• What are medical treatments for renal artery stenosis?
• What surgical procedures are available for renal artery stenosis?
• Which patients can benefit from surgical procedures for renal artery stenosis?
• Renal Artery Stenosis At A Glance
• Patient Comments: Renal Artery Stenosis - Cause
• Patient Comments: Renal Artery Stenosis - Diagnosis
• Find a local Nephrologist in your town
• Renal Artery Stenosis Index

A search for renal artery stenosis may be undertaken in patients with progressive kidney failure of unknown cause, or in individuals with difficult to treat high blood pressure (hypertension that does not respond well to medications). The diagnosis of renal artery stenosis may be considered when any or all of the following are present:

• High blood pressure that is difficult to control with the usual medications.
  
  
• An abdominal bruit (a rubbing sound heard with a stethoscope placed on the abdomen suggesting a narrowed vessel) along with high blood pressure.
  
  
• Moderately to severely elevated blood pressure, with an onset before age 30 or after age 50.
  
  
• Moderately to severely elevated blood pressure in a person with known atherosclerosis elsewhere in the body (history of heart attack or stroke).
  
  
• Easily controlled high blood pressure that becomes difficult to control.
  
  
• Worsening of kidney function after initiation of certain blood pressure medications [angiotensin converting enzyme inhibitor (ACE Inhibitor), or angiotensin receptor blocker (ARB)].

Several tests exist to detect any evidence of renal artery stenosis. They can be divided into imaging tests and functional tests. The imaging tests provide a picture of the blood vessel and its anatomy and reveal the degree of narrowing. The functional tests provide information about whether the narrowing is significant enough to cause the high blood pressure or kidney dysfunction. Each of these tests has advantages and shortcomings.