Treatment of Vascular Diseases of Kidneys in South Africa

It is often associated with hypertension/high blood pressure. Decreased blood flow to the kidneys due to renovascular disease may cause an excessive amount of renin (a powerful hormone that increases blood pressure) to be produced.

The main causes of renal vascular disease include atherosclerosis, injury, infection, inflammatory disease, aneurysm, pregnancy, surgery, tumor, certain medications and birth defects. Other risk factors for renal vascular disease include:
• Diabetes
• Older age
• Smoking
• High cholesterol
• Female
• High blood pressure

The symptoms of renal vascular disease may mimic other medical conditions and it is always wise to consult your health care provider for a diagnosis. They include:
• High blood pressure
• Increased urea in the blood
• Discolored areas of the toes and feet
• Kidney failure
• Confusion
• Weight loss
• Fever
• Muscle aches
• Sudden onset of flank pain
• Blood in the urine
• Nausea and vomiting
• Abdominal pain
• Diarrhea

Diagnosis of the renal vascular disease involves a review of your medical history as well as a physical exam. Other tests that may be ordered include:
• Arteriogram: This is an X-ray image of the blood vessels used to check for an aneurysm, narrowing, or blockages. A dye is injected through a thin, flexible tube placed in an artery to make the blood vessels visible on X-ray. This test is also known as an angiogram.
• Renography: This test is used to check the function and structure of the kidneys. It uses a small amount of a radioactive substance to help view the kidneys.
• Duplex ultrasound: This test is done to check blood flow and the structure of the renal veins and arteries.
• Magnetic resonance angiography (MRA): This test uses a combination of intravenous (IV) contrast dye and magnetic resonance imaging (MRI) technology to see blood vessels.

• Treatment varies depending on the type of renal vascular disease that is present. Medications and surgery are the most common treatments. Some of the treatment options include:
• Blood pressure lowering medications which may be used to treat high blood pressure.
• Medications to lower cholesterol may be prescribed for atherosclerosis.

• Thrombolytic medication may be infused into the renal artery for many hours to many days to break up the clot.
• Anticoagulants which keep blood from clotting are used to treat renal vein thrombosis.
• Diet and exercise are urged to lower blood pressure.
• Angioplasty is performed to keep the artery open.
• Open surgery is performed to bypass the blocked renal artery.
• A renal artery aneurysm in a pregnant woman or a woman of childbearing age is usually treated with surgery due to the increased risk for rupture.