Renal Artery Stenosis

Question: What are the symptoms of renal artery stenosis. On diagnosis, is surgery the only mode of treatment.? Besides surgery, is there any medication available for treatment of renal artery stenosis.

Answer: Well you may have lower back pain, a positve kidney puch sign and a decrease in urine output. Actually no, you can have an artey stent done by a nephrologist or an interventional radiologist...

Question: Why are ACE inhibitors contraindicated in renal artery stenosis? Text books just say it's contraindicated. Anyone know why? What will happen if we give ACEI to a renal artery stenosed patient?

Answer: Angiotensin II causes vasoconstriction in the efferent (outgoing) arterioles in the glomerulus, which increases perfusion pressure and GFR. This is the same (normal) response to maintain GFR with dehydration (where low volume is the cause of reduced perfusion). With stenosed renal arteries, afferent flow cannot be increased, angiotensin II can actually become the only mechanism by which the kidney can increase filtration, and with severe stenosis, efferent arteriole constriction is crucial for maintaining some degree of filtration. ACE inhibitors would prevent conversion of Ang. I (which is inactive) to Ang. II, and therefore make everything worse by removing the kidney's only remaining regulatory mechanism as well as cutting the perfusion pressure and eliminating what little renal function remains. With tubular cells that are already less effective due to damage from chronic ischemia, the resulting decrease in GFR would effectively accelerate kidney failure .

Question: What is the prognosis for renal artery stenosis? My future mother in law was just told that she had a narrowing artery in her kidney. She's been having unexplained high blood pressure and panic attacks which prompted her to go to the doctor for tests, and found this out. They told her that she would need some stenting done. What is the prognosis for this? She is in her mid 40's and overall in good health, never been a smoker. I already know *about* the condition, but I can't seem to find any information about a prognosis...which is what I'm asking about for any one who may have familiarity on the subject.

Answer: See Merck Medical manuals online, on this subject: http://www.merck.com/mmpe/sec17/ch238/ch… and try a search at the Natl Institute of Diabetes and Digestive and Kidney Diseases, both for answers and experts http://www2.niddk.nih.gov/

Question: Can you help me with my A&P question? Its about renal artery stenosis? I need to know why RAS causes high blood pressure. I also need to know the effects it would have on blood levels of potassium, sodium, aldosterone, angiotensin II, and renin. I really appreciate any help! Thanks!

Answer: Ok, here it goes! In RAS, the kidney is basically being starved for blood. When a stenosis is present, the pressure distal to the stenosis drops significantly. Essentially, the kidney is fooled into thinking the blood pressure is low in the entire body instead of just the kidney itself. In response to the low pressure in the renal artery, the kidney releases Renin, which in turn causes a rise in Angiotensin II and Aldosterone. Angiotensin II is the bad guy in renal-induced hypertension because it signals the kidney to retain water by reducing the amount of filtration in the glomerulus (causing the high BP!) Aldosterone is made in response to the high Renin and Angiotensin II levels; it raises blood pressure by signalling the kidney to retain sodium. When sodium is retained, so is water (due simply to osmotic forces). This is where you need to be careful -- just because sodium is retained in the kidney tissues, it doesn't mean it is retained in the blood. Due to the extra volume of water being retained, the sodium in the blood is diluted, so its concentration goes down ever so slightly. As far as potassium, it's levels decrease in the blood (due to Aldosterone) because for every molecule of Sodium you retain, you lose one molecule of Potassium in the urine. Hope this is what you need!

Question: Anyone out there with Renal Artery Stenosis? I am 33 years old and have developed hypertension. Despite diet and lifestyle changes, my blood pressure keeps escalating. My doctor said it might be Renal Artery Stenosis and he wants to test me for this disease. I've been reading about it online, but would appreciate hearing from someone who has experienced or is experiencing this firsthand. I have been on lisinopril for the past year.

Answer: It is possible that you have renal artery stenosis (RAS), but much more likely that you haven't. Basic iblood tests such as measuring plasma renin activity and aldosterone can support a diagnosis, but can neither confirm it or rule it out. The gold standard test is renal angiography (X rays of the renal arteries after receiving a contrast medium intravenously) or magnetic resonance angiography. The bottom line is that whether you have it or not is irrelevant unless your blood pressure cannot be controlled by medication, or if your kidney function is impaired. Lisinopril is a perfectly good choice for RAS associated hypertension, and it it is also one of the first choices in the control of high blood pressure for other reasons (ie "essential" hypertension, which accounts for about 90% of all hypertension, and is most likely what you have.) Hope this helps.

Question: i need angioplasty for renal artery stenosis treatment how long should i take off from work?

Answer: depends on on well you take things. i took off the day of surgery and was back to work with limits on the third day.

Question: Renal artery stenosis? Had abnormal utra sound of kidney. Doctor sending me to nephrologist, may be renal artery stenosis, does anyone have information about this or has anyone been diagnosed with this?

Answer: This topic will help you out as having no symptoms carries no weight, think of future if left alone : Alternative names Return to top Renal artery occlusion; Stenosis - renal artery; Occlusion - renal artery; Fibromuscular dysplasia (FMD) Definition Renal artery stenosis is a narrowing or blockage of the artery that supplies blood to the kidney. It is caused by atherosclerosis, fibromuscular dysplasia of the renal artery wall, or scar formation in the artery. (See also atheroembolic renal disease.) Causes, incidence, and risk factors Renal artery stenosis is caused when atheroembolic renal disease results in narrowing of the renal artery. Fibromuscular disease, a condition more common in young women in which fibrous tissue grows in the wall of the renal artery and narrows it, is a second cause. It may also be caused when scar tissue forms in the renal artery after acute arterial obstruction or traumatic injury to the kidney. Renal artery stenosis often causes hypertension (high blood pressure) with no other signs of its presence, and it is usually discovered in investigation for the cause of hypertension that is difficult to control. Renal artery stenosis is, in fact, among the most common causes of secondary (caused by another condition) hypertension. The disorder may also be discovered when a bruit (loud whooshing sound) over the kidney is noted on examination with a stethoscope (auscultation). In the elderly, renal artery stenosis is most commonly associated with atherosclerotic disorders, including atherosclerotic heart disease. Atherosclerotic plaque deposits within the renal artery and causes it to become stenosed (narrowed). Fibromuscular dysplasia is a congenital disorder involving thickening of the arterial wall and is a cause of renal artery stenosis in younger adults, particularly women 20 - 40 years old. Renal artery stenosis may cause chronic renal failure if it affects both renal arteries or if the high blood pressure associated with this condition is prolonged or severe. Symptoms There are usually no symptoms. Signs and tests The blood pressure may be high, and there may be a history of high blood pressure that doesn't respond to medication or is difficult to control. A bruit may be heard on examination with a stethoscope (auscultation) over the kidney. * A radionuclide renogram may show decreased blood flow. The value of radionuclide scanning is increased if the test is done twice: once after a dose of captopril and once without the captopril. * An MRI, kidney CT scan, or kidney ultrasound may indicate a decreased size of the kidney, and/or a decrease in blood flow through the artery because the artery has become narrow. * Renal arteriography shows the exact location of the stenosed (blocked) area. This disease may also alter the results of the following tests: * Urine specific gravity * Urine concentration test * Renal perfusion scintiscan Treatment The treatment varies depending on the extent and severity of the symptoms. If the stenosis results in failure of a kidney, the second kidney may take over filtering and urine production for the body. Surgical repair of the stenosed area may be possible. A balloon angioplasty (a radiographic procedure during which a balloon-tipped catheter is threaded through the artery) or a stent placement across the stenosis may be an alternative to surgery to open the stenosed area. Antihypertensive medications may be needed to control high blood pressure. Expectations (prognosis) Renal artery stenosis may cause eventual failure of the kidney if it progressively blocks the artery. This may result in chronic renal failure if there is only one functional kidney or if both renal arteries are affected. Renal hypertension caused by renal artery stenosis may be difficult to treat. Surgical or balloon catheter repair often successfully opens the stenosed area. However, stenosis may recur. Complications * Hypertension * Malignant hypertension * Chronic renal failure Calling your health care provider If your history indicates a high risk for renal artery stenosis, make an appointment to see your health care provider. However, decreased urine volume may be an emergency symptom indicating renal failure. Prevention Some cases of renal artery stenosis may be prevented by avoiding smoking.

Question: renal artery stenosis???? i have a 4 year old girl patient suspected to have renal artery stenosis.. i just want to know: WHAT IS THE NORMAL DIAMETER of renal artery in pediatric ???

Answer: A good radiologist would know. (or at least know where to find out).

Question: Has anyone had a stent put in for renal artery stenosis? Thanks,?

Answer: Many have been implanted stents for renal artery stenosis. Several of them get good control of hypertension.

Question: what is the icd9 code for stenosis of the renal artery? cant find the correct code

Answer: what are you billing and for what state, state of pa welfare is one code, state of wva medicare is a different code, maryland medicaid and medicare both use different codes and so do fl. and is it out pt or in pt and was there surgery involved at this admission. all this detail must be considered before giving correct code. i was a hospital legal clerk for 15 years at a trauma hospital PS i called my local libary, they stated that most libarys carried a medical section that include ICPcode books, take a trip, iam sure they keep updated code books there or at the local college libary for students. good luck, iam still looking for you