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Forum Name: Miscellaneous Nephrology Topics

Question: Renal Artery Stenosis - is surgery the only treatment?


 bones201 - Tue Mar 04, 2008 8:40 pm

Hi I am a 41 year old
female who always had normal bp 120/80. Last wk my bp was check and was 176/126. I went directly to my doctor who did blood work, put me on Tekturna. He also performed a echo on my heart and an Ultrasound on my kidneys. He stated that there appears to be blockage. I wasn't sure if he said there was 70% blockage or 70% of his opinion he felt it was blocked. He is ordering a MRA to further diagnose. I also have calf pain. My blood pressure is now normal with the mediciation. He says I can return to exercising at the gym and everything else. I would like to know if the calf pain indicates a more serious time frame for me to be tested and also if it is blocked is surgery the only option. Is there any mediciation for this. Also, are my kidneys damaged from this? Thank you for your time. P.S. All blood work came back normal.
 Dr. A. Madia - Fri Mar 28, 2008 8:41 am

User avatar Hi,

High BP is of two types, Primary and Secondary. Secondary hypertension is one which has a specific 'cause' like renal or hormonal impairment. Primary is just there, like in many middle or old age people. Since you are relatively young and your BP has come to light a little abruptly, your doctor very rightly subjected you to a renal Doppler.

Renal artery narrowing is a major trigger for development of hypertension. This type of hypertension sometimes proves difficult to control and Tekturna [aliskiren] is a recent medicinal class specifically to control renal or High Renin hypertension.

If renal artery stenosis is confirmed on MRA, it can be very well treated with a procedure called Renal Angioplasty with Stent insertion, this is just like what they do in a heart artery in a heart attack. Successful opening of a renal artery stenosis many times cure the blood pressure. Also it prevents the kidney from getting damaged.

Calf pain could be non specific. However in a smoker it may herald blockage of leg arteries. In such a case it may be advisable to go for a leg artery Doppler too, and if positive an MRA of legs.


Take care,


Apurva

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