Renal Hypertension: What Causes It?

  • Renal hypertension is blood pressure caused by kidney disease.
  • A narrowing of the kidney’s arteries causes the kidneys to retain sodium and water, leading to high blood pressure.
  • Renal hypertension may be treated with medications or procedures such as angioplasty, stenting, or surgery.

Renal hypertension or renovascular hypertension is high blood pressure that results from kidney disease. Blood pressure drugs can manage the condition, but some people can be treated by angioplasty, stenting, or surgery on the kidney’s blood vessels.

Causes of Renal Hypertension

Renal hypertension results from renal artery stenosis, or a narrowing in the arteries responsible for delivering blood to the kidney. When there’s inadequate blood flow to the kidneys, the organs respond by releasing hormones that encourage the body to hold onto sodium and water, causing the blood pressure to go up.

The narrowing of renal arteries is often caused by hardening of the arteries that also causes many heart attacks and strokes. Another cause may be fibromuscular dysplasia, a condition where the renal arteries develop abnormally for unknown reasons.

Symptoms of Renal Hypertension

Renal hypertension doesn’t usually cause symptoms. High blood pressure also causes no symptoms, but extremely high blood pressure usually causes headaches, confusion, double or blurry vision, blood in urine, or nosebleed. However, most people with renal hypertension don’t experience any symptoms, which makes the condition very dangerous because it can damage your organ without you realizing it.

Renal hypertension can result in chronic kidney disease, which also causes no symptoms in its early stage. Renal hypertension may only be diagnosed when a person has uncontrolled high blood pressure that doesn’t go away even after multiple medications.

Treatments for Renal Hypertension

The initial treatments for high blood pressure in renal hypertension are medicines. These medicines include ACE inhibitors (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers). Often, a combination of blood pressure drugs is needed to control the high blood pressure.

However, for some people with renal hypertension caused by narrowing of the renal artery, even taking a combination of medications may not efficiently manage blood pressure. This is when a procedure to improve blood flow to the kidneys may be necessary. Options include:

Angioplasty. This procedure involves inserting a catheter through a groin artery and into the renal artery. A balloon is then momentarily inflated to widen the artery and improve blood flow.

Stenting. A wire-mesh stent inside the renal artery is expanded to keep the artery open after the doctors remove the balloon.

Surgery. The narrowed renal artery is sewn into a healthy blood vessel next to it. T

Results of Treatment

Surgery may be an effective option for people with uncontrollable blood pressure even after a medication or those who have sensitivities to blood pressure medication.

If a procedure is essential, stenting or angioplasty are usually performed. However, these procedures are not more effective than taking medications. Still, undergoing procedures may help some people with renal hypertension. These procedures often work better when only one artery is narrowed.

Source: WebMD