Renal artery stenosis is the narrowing of one or both arteries that carry blood to your kidneys (renal arteries). Narrowing of the arteries prevents normal amounts of oxygen-rich blood from reaching your kidneys. Your kidneys need adequate blood flow to help filter waste products and remove excess fluids. Reduced blood flow may increase blood pressure and injure kidney tissue.

Doctors at Mayo Clinic provide many diagnosis and treatment options for renal artery stenosis. Mayo Clinic is one of the largest kidney disease treatment centers in the United States. Doctors trained in kidney diseases (nephrology and hypertension), vascular and endovascular surgery, diagnostic and therapeutic (interventional) radiology, heart (cardiovascular) diseases, and vascular medicine work together to evaluate and treat each person.

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Doctors from the Vascular Center work with doctors trained in diagnostic and therapeutic (interventional) radiology, kidney disease (nephrology), and heart disease (cardiology) to diagnose and treat renal artery stenosis.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Doctors trained in vascular surgery, diagnostic and therapeutic (interventional) radiology, heart (cardiovascular) diseases, and kidney disease (nephrology) and high blood pressure (hypertension) diagnose and treat people who have renal artery stenosis.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

The Gonda Vascular Center brings together the expertise of doctors trained in vascular and endovascular surgery, kidney disease (nephrology), diagnostic and therapeutic (interventional) radiology, heart (cardiovascular) surgery, and cardiovascular diseases. In addition, doctors in the Cardiovascular Health Clinic offer evaluation and preventive services to help you lessen your risk of blood vessel diseases such as renal artery stenosis.

Mayo Clinic in Rochester, Minn., ranks #1 for kidney disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., is ranked among the Best Hospitals for kidney disorders, and Mayo Clinic in Jacksonville, Fla., is ranked high performing for kidney disorders by U.S. News & World Report.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Diagnosis at Mayo Clinic begins with:

  • A physical exam that includes your doctor listening through a stethoscope for sounds that may mean the artery to your kidney is narrowed
  • Questions about your medical and family history
  • Blood tests to evaluate kidney function and exclude other conditions

Doctors who specialize in the interpretation of medical images (radiologists) conduct tests to check your blood vessels and kidneys. You may need one or more of the following imaging tests to find the narrowing in the renal artery and determine its severity:

  • CT scan. During a CT scan, an X-ray machine linked to a computer creates a detailed image that shows axial (cross-sectional), coronal and sagittal images of the renal arteries. You may receive a dye injection to show blood flow.
  • Magnetic resonance angiography (MRA). MRA uses radio waves and strong magnetic fields to produce detailed 3-D images of the renal arteries and kidneys. A dye injection into the arteries outlines blood vessels during imaging.
  • Ultrasound. High-frequency sound waves help your doctor see the arteries and kidneys and check their function. This procedure also helps your doctor find blockages in the blood vessels.
  • Renal arteriogram. This special type of X-ray helps your doctor check blood flow and find the blockage in the renal arteries. Before an X-ray is taken, doctors inject a dye into the renal arteries though a long, thin tube (catheter) to outline the arteries and show blood flow more clearly. This is often performed at the time of restoring the blood vessel opening with a stent.

Read more about CT scan and ultrasound.

If a renal artery is narrowed or blocked, your doctor will talk with you about your treatment options. Treatment depends on the cause of the blockage and severity of your blood pressure and kidney dysfunction. Mayo Clinic doctors work to reduce your risk of kidney failure, improve blood pressure and relieve narrowing in the renal arteries.

Lifestyle changes, blood pressure medications and other medications to control cardiovascular risk factors can help some people prevent or slow the development of renal artery stenosis. Lifestyle changes such as eating healthy, exercising and smoking cessation are also important parts of treatment.

Surgery

When lifestyle changes and medications aren't enough to manage renal artery stenosis, you may need repair of the arteries (revascularization) to restore blood flow to your kidneys. Revascularization options include:

  • Renal angioplasty and stenting. This procedure opens the narrowed arteries. During an angioplasty, your doctor threads a long, thin tube (catheter) through an artery to the affected area. The doctor inflates a balloon on the tip of the catheter and flattens the fat and cholesterol buildup (plaques) onto the artery walls. In most cases, your doctor also will place a small wire tube (stent) to keep your artery open.
  • Renal artery bypass. You may need open surgery if you have severe renal artery stenosis that isn't receptive to stenting or if stenting has failed. During a bypass, your doctor grafts a substitute artery to the renal artery to make a new route for blood to reach your kidneys.
  • Renal endarterectomy. This procedure involves removing plaques in the renal arteries. Your doctor makes an incision in the aorta to remove the plaque from the renal artery, then stitches closed the aortic incision.

In some cases, careful management and observation may be all you need.

Doctors at Mayo Clinic have a long-standing interest in research related to renal artery stenosis. Findings from research studies can lead to new and improved treatments. Current research efforts focus on:

  • Assessing the most effective renal artery stenosis treatments
  • Exploring how renal artery stenosis develops
  • Finding the causes of renal artery stenosis
  • Determining the most appropriate treatment for people who have high blood pressure caused by renal artery stenosis
  • Increasing recovery of kidney function after treatment

Researchers at Mayo Clinic are studying new diagnostic tools such as the multidetector CT scan and blood oxygen level dependent (BOLD) magnetic resonance (MR) imaging. Mayo Clinic researchers developed these imaging tools, which use 3-D images to assess kidney function. BOLD MRI can show whether your kidney is getting sufficient oxygen and can recover after renal revascularization.

Learn about renal artery disease research in Mayo Clinic's online research magazine, Discovery's Edge.

Publications

See a list of publications from Mayo Clinic doctors on renal artery stenosis on PubMed, a service of the National Library of Medicine.

Nov. 20, 2012