Renal Artery Stenosis Treatment in South Africa

• Atherosclerosis - This is the clogging, narrowing and hardening of the renal arteries due to plaque build-up. Plaque is a substance made of cholesterol, fat, calcium and other material found in the blood.
• Fibromuscular dysplasia (FMD) - This occurs when there is abnormal growth of cells on the wall of the renal artery, which can cause blood vessels to narrow.

• Lack of physical exercise
• Diabetes
• Smoking
• High blood pressure
• Abnormal blood cholesterol levels
• A family history of heart disease
• Older age

They include hypertension that is difficult to control with medication, kidney dysfunction and pulmonary edema.

Imaging tests used to diagnose the condition include:

• Catheter angiogram: It is a special x-ray in which a catheter is threaded through the large arteries to the renal artery. This is done by a radiologist. Anaesthesia is not needed but to lessen anxiety a sedative may be given.
• Magnetic Resonance Angiogram (MRA): This test uses magnets and radio waves to produce detailed images of the internal organs without using x rays. A mild sedative may be given to you if you have a fear of confined spaces. The images are then interpreted by a radiologist.
• Computerized tomographic angiography (CTA) Scan: This test uses both computer technology and x rays to create images. The procedure is done by an x-ray technician and then interpreted by a radiologist.
• Duplex Ultrasound: This test uses both traditional ultrasound and Doppler ultrasonography. It is performed by a special technician. The images are the interpreted by a radiologist.

Treatment includes surgery, medication or lifestyle changes.

• Surgery: The procedures are done by a vascular surgeon in a hospital. Anesthesia is required. The following are the different surgical procedures:

• Endarterectomy - It involves cleaning out the artery. A vein or synthetic tube then connects the kidney to the aorta.
• Angioplasty and stenting - A catheter is inserted into the renal artery. In addition, a stent is positioned in the artery to keep plaque flat and artery open.

• Medications: Medications are taken to lower the blood pressure, to help the kidneys remove fluid from the blood and to lower the cholesterol to prevent plaque build-up.
• Lifestyle changes: Maintaining a healthy body weight, diet and physical exercise are good ways to prevents plaque build-up. If you smoke, quitting will help protect your kidneys and other organs.