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Renal hypertension

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Renal hypertension synonymous as renovascular hypertension; is rise in blood pressure due to problem in the kidneys. Renal hypertension or renovascular hypertension is most common cause of secondary hypertension. One of the primary causes behind renal hypertension is narrowing of kidney’s arteries, as a result of which low blood flow to the kidneys.

Symptoms of renal hypertension

There are no specific symptoms of renal hypertension but elevated blood pressure can cause:

  • Vomiting
  • Confusion
  • Nausea
  • Nosebleed
  • Change in vision
  • Bad headache
  • Bloody urine
  • Blurred vision

People who have a history of high blood pressure and have a medical history of heart failure are at high risk of having renal hypertension. Furthermore, previous episodes of kidney failure can also cause renovascular hypertension.

Causes of renal hypertension

The primary cause of renal hypertension is renal artery stenosis. Renal artery stenosis is the narrowing or blockage of renal artery that supplies blood to the kidneys. Though many diseases cause renal artery stenosis the two main primary causes are atherosclerosis and fibromuscular dysplasia.   

Atherosclerosis: It’s often caused by plaque (cholesterol) deposits inside renal arteries. The atherosclerosis can begin in the aorta and extend to the renal artery. 90% renal hypertension cases occur due to atherosclerosis.

Fibromuscular dysplasia: it’s a genetic disorder occurring mostly in female in the age group of 30s, often with a history of smoking. The fibrous tissues of the renal arterial wall thicken, that hinders blood flow to the kidneys.  It is the less common cause for about 10% of the cases accounts for renal hypertension.

When blood pressure in the kidneys drop due to reduced blood flow, then the hormones secreted reduce urine formation by reabsorbing sodium and water. This leads to less urine output and increased blood volume and blood pressure in the body.

Are there any complications of renal hypertension?

Renal hypertension leads to gradual decline in kidney function and if blood pressure inside renal arteries increases to a large extent and is not controlled, then it can lead to chronic kidney disease.

Diagnosis of renal hypertension

You will need to fix an appointment with a nephrologist who will perform the diagnosis. The diagnosis involves viewing the condition of the renal arteries with the help of the following techniques :

  • Doppler ultrasound
  • Magnetic resonance angiography
  • Renal arteriography
  • Angiotensin-converting enzyme (ACE) inhibition renography
  • CT angiography

Treatment of renal hypertension

There are several medical treatments for controlling renal hypertension. Your doctor is most likely to prescribe anti hypertensive drugs to lower the elevated blood pressure. The common medicines used are alpha blockers, beta blockers, diuretics, angiotensin receptor blockers, ACE inhibitors, and vasodilators.

You will be prescribed a specific combination and dosage which will depend on the condition of your renal arteries.

Your doctor might resort to other lines of treatment when blood pressure has reached abnormal levels and is caused mainly by renal artery stenosis. Angioplasty is done to widen the renal artery and normalize blood circulation. Stenting (inserting a stent inside the artery) is an advanced technique to improve blood flow inside the renal artery.

Surgical treatments for renal hypertension involve revascularization (bypass surgery) and endarterectomy. Both these techniques are invasive procedures.

Can renal hypertension be prevented?

You can always reduce your chances of having renal hypertension by following a healthy lifestyle. Take the following steps:

  • Check your weight. Make sure it’s within the healthy range
  • Exercise daily- get your body moving. This improves blood circulation
  • Get your cholesterol and lipid profile checked in routine diagnosis
  • Eat healthy- avoid unhealthy fats, carbohydrates and cholesterol rich foods
  • Drink plenty of water

The only way to prevent renal hypertension is taking good care of your kidneys. Follow the treatment plan as determined by your doctor to recover quickly.

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Written by: Saptakee sengupta
Date last updated: January 29, 2015