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, being physically active and stopping smoking are also important parts of treatment.
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.
April 30, 2015
- Renal artery stenosis. National Kidney and Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/RenalArteryStenosis/. Accessed March 5, 2015.
- Goldman L, et al. Vascular disorders of the kidney. In: Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed March 3, 2015.
- Ferri FF. Renal artery stenosis. In: Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed March 3, 2015.
- Taal MW, et al. Renovascular hypertension and ischemic nephropathy. In: Brenner & Rector's The Kidney. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed March 5, 2015.
- Tafur-Soto JD, et al. Renal artery stenosis. Cardiology Clinics. 2015;33:59.
- Textor S. Treatment of unilateral atherosclerotic renal artery stenosis. http://www.uptodate.com/home. Accessed March 3, 2015.
- Textor S. Treatment of bilateral atherosclerotic renal artery stenosis or stenosis to a solitary functioning kidney. http://www.uptodate.com/home. March 3, 2015.
- AskMayoExpert. Renal artery angioplasty and stenting. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Cooper CJ, et al. Stenting and medical therapy for atherosclerotic renal-artery stenosis. New England Journal of Medicine. 2014;370:13.
- Weight management and blood pressure. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Weight-Management-and-Blood-Pressure_UCM_301884_Article.jsp. Accessed April 7, 2015.
- Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. April 8, 2015.
- Textor SC (expert opinion). Mayo Clinic, Rochester, Minn. April 8, 2015.