Renal artery stenosis

This condition may result in secondary hypertension and secondary hyperaldosteronism.
Other possible features include:
- coexistant cerebrovascular, cardiovascular or peripheral vascular disease
- deterioration of renal function following treatment with ACE inhibitor
- signs of coexistant vascular disease
  - carotid or femoral bruit
  - abdominal bruit
  - absent peripheral pulses
A small kidney will be seen on intravenous urography on the affected side with a delayed and persistent nephrogram
Causes
- atherosclerosis (>90%) in the adult population
- fibromuscular dysplasia (FMD) – common in younger female patients
Management
- Fibromuscular dysplasia responds well to balloon dilatation, often resulting in a normal blood pressure.
- Atherosclerosis may respond to balloon dilatation but the effect on blood pressure is unpredictable
- If renal artery stenosis is bilateral, balloon dilatation often leads to improved renal function.