Renovascular diseasesRenovascular diseases

Renovascular diseases

Renovascular diseases are those diseases that deal with the blood supply to kidneys & the out flow of blood from it. Acidosis may lead to gout, kidney malfunction or failure, high blood pressure.

Types of renovascular diseases

  1. Renal artery stenosis
  2. Renal artery thrombosis
  3. Renal artery aneurysm
  4. Atheroembolic renal disease
  5. Renal vein thrombosis
Renovascular Diseases
Renovascular Diseases

Types of renovascular diseases are:

  1. Renal artery stenosis

    (RAS) is a kind of systemic atherosclerosis affecting the renal artery. This is the act of narrowing or leading to blockage of an artery to the kidneys. Kidney failure and high blood pressure are the possible consequences of the given condition. People who smoke are prone to developing RAS. Therefore, high cholesterol, high triglycerides, diabetes, obesity, and history of RAS in the family are some of the other risk factors that contribute to RAS. Essential hypertension is known to both contribute and be consequent of RAS.

  2. Renal artery thrombosis.

    This is a blood clot in an artery likely to be supplying kidney. It may lead to a halt in the flow of blood as well as result in kidney failure.

  3. Renal vein thrombosis.

    This is formation of a clot in a vein to a kidney.

  4. Renal artery aneurysm.

    This is a bulging weak area in the wall of an artery to a kidney. Many are small and do not produce symptoms. Renal artery aneurysm is not very common to diagnose and can be diagnosed incidentally during the investigation of other diseases.

  5. Atheroembolic renal disease.

 This occurs when a part of plaque from a larger artery float and be carried by the blood. This coil Pros atheroma and occlude small renal arteries. This disease is gradually becoming the leading cause of kidney disorders of the elderly.

Renin is another potent hormone, which increase blood pressure. Renovascular diseases that cause decreased blood flow to a kidney may lead to renin buildup because too much is being produced. An example is increased blood pressure.

What cause renovascular diseases?

Thus, the causes of renovascular diseases will depend on the diseases that are involved. The main causes are:

  • Atherosclerosis
  • Diabetes
  • Hypertension
  • Morbid obesity
  • Fibromuscular dysplasia
  • Injury
  • Infection
  • Inflammation or any other associated diseases
  • Surgery
  • Tumor
  • Aneurysm
  • Pregnancy
  • Certain medicines
  • Birth defect

Who predisposed for renovascular diseases?

Risk factors for renovascular diseases include:

  • Older age
  • Being a woman
  • Atherosclerosis
  • High new antihypertensive therapy in the elderly
  • Smoking
  • High cholesterol
  • Diabetes

Diagnosis of renovascular diseases

Your healthcare provider reviews your past medical history and do a check up on you. You may also need these tests:

  • Arteriogram (or angiogram). This is the X-ray of the blood vessels that is performed to determine signs of aneurysms, constriction, or blockage. A dye or contrast medium is passed into the system through a long, thin tube called catheter inserted into an artery. This dye ensures that the Blood vessels become observable in X-rays.
  • Duplex ultrasound. This test is carried out to determine the status of the renal veins and arteries in terms of blood flow and formation. The term ‘duplex’ implies 2 kinds of ultrasound are utilized. The first include a picture of the specific renal artery under analysis. The second mode monitores the circulation.
  • Renography. It is one test that is applied in an attempt to assess the workings of the kidneys as well as their condition. It belongs to the category of nuclear medicine. It implies that during the test a little bit of the radioactive substances is used to help see the kidneys.
  • Magnetic resonance angiography (MRA). This test employs MRI by using magnetic fields and radio wave together with IV contrast aide for vascular visualization. Contrast dye makes blood vessels look like a solid object on the MRI picture. This enables the healthcare provider to actually see the veins and the way through which the blood circulates.

Methods of treatment for renovascular diseases

Treatment will also depend with the kind of renovascular diseases that you have as indicated below.

Renal artery occlusion: If the blockage is detected early enough and especially if the patient has only one kidney, then the doctors will normally embark on vigorous treatment. They may also employ specific types of medication such as the thrombolytics (for instance streptokinase* or alteplase) which is used in dissolving clots. This treatment can only be if the blockage is not total and if it is carried out immediately. Proper treatment should be sought as early as possible as the kidneys require blood supply. It can also attempt to avoid further clots with blood thinners like warfarin or heparin, especially if deep vein thrombosis is a threat.

In some extreme instances, the doctor may attempt at using surgery in order to attempt to clear out the artery. Similar to ischemia, surgery has to be performed shortly after the blockage has been discovered. It is usually performed if the problem is precipitated by trauma and not by a disease.

If the blockage is not complete, then balloon angioplasty if the kidney function or renal artery bypass surgery if blood pressure can also be considered. At times, these cases can go away after undergoing this procedure, although high blood pressure remains a chronic condition in the majority of the population.

Renal vein thrombosis: The primary management is the anticoagulation therapy which is aimed at the prevention or dissolution of additional blood clots with the use of warfarin or heparin. Blood clot may also be removed through surgery though this procedure is rare and mostly used in severe cases. In instances of starvation, food products are introduced in the management of this condition while in cases of dehydration, liquids are considered to be administered for the purpose of replenishing the liquids back into the body.

Unfortunately, renal atheroembolism does not have specific treatment; however, following the patient’s conditions and making sure that their kidneys are not damaged is significant. The objective is to stop it worsening or exacerbating its state in the process.

Renovascular diseases cannot be prevented, but it is possible to delay it by managing conditions that exert their effect on it such as hypertension, hyperlipidemia, and diabetes. Dietary guidelines and aerobic fitness are recommended for the people on the use of prescription medications.

For example, in renal vein thrombosis it is realized that some of these embolisms can be prevented with measures that keep people from getting dehydrated; while they are ill. In other words, getting enough fluids, especially during an illness such as acute gastroenteritis or the flu. This is especially so for the young ones since their learning process occurs at a faster rate.

Thus, if such factors as smoking and obesity are excluded, the likelihood of developing renal atheroembolism will be considerably lower. Thus, for people with diabetes, blood sugar control is very effective in preventing this pathology.

Symptoms and treatment of renovascular diseases

  1. Renal artery stenosis

 Symptoms:

  • Persistent hypertension, the level not coming down with 3 or more medications
  • Some of the causes that lead to the malfunctioning of the kidneys are: High level of urea, a waste product that is processed in the kidneys.
  • Unexplained kidney failure
  • Kidney damage when starting an ACE inhibitor for the first time for a high blood pressure or heart issues.

 Treatment

1.Medical treatment:

  • Antihypertensive/anti high blood pressure agents for managing hypertension
  • Cholesterol reducing drugs for atherosclerosis
  • Mention of the management of other related illnesses for instance diabetes.

2.Surgical treatment:

  • Angioplasty which is the opening of a renal artery using a primary balloon or some other method, use of stents which are thin metallic coils that are implanted within the arteries to ensure that they do not close.

Arterial surgery where the blockaded renal artery is detached and another suited one is connected to the kidney.

Renal artery stenosis
Renal artery stenosis

Renal artery thrombosis

Symptoms:

  • Perineal pain, flank pain, and soreness of the side of the body that is involved and pain that appears suddenly usually between the ribs and the upper border of hip bone.
  • Fever
  • Hematuria
  • Nausea and vomiting
  • An acute renal failure
  • High blood pressure

An incomplete clot formation or clot reformation may not trigger any signs or symptoms and therefore will go unnoticed.

Treatment

The intervention used in acute cases is thrombolytic medicine where the clot-busting medicine is infused through renal artery from several hours to finally several days.

In certain circumstances, surgery to remove the clot or to bypass the artery, may be performed.

Renal artery aneurysm

Symptoms:

  • Often no symptoms
  • High blood pressure

Mainly flank pain and gross hematuria if there has been a tear in the aneurysm

Treatment

The management of a renal artery aneurysm depends with symptoms and expansion of this aneurysm’s size together with its position. A few which are quite small may not be treated at all but may be merely observed to determine if the size increases or if it causes complications.

For big, rupturing, or expanding kinds of aneurysms, surgeons may decide to operate. It may also be used in cases of aneurysms resulting in inadequate blood supply to the kidney and elevated blood pressure and aneurysms with signs and symptoms.

A renal artery aneurysm is usually treated through surgery because of the higher likelihood of bursting or rupture specifically when the woman is pregnant or of the child-bearing age.

Atheroembolic renal disease

Symptoms:

  • This includes over growth or opulent, skin lesions or any red or purple color of the skin.
  • Black or yellow stains on the toes especially on the nails and other parts of feet.
  • Kidney failure
  • Belly pain
  • Diarrhea
  • Nausea, vomiting
  • Confusion
  • Weight loss
  • Fever
  • Muscle aches

Treatment

In management, drugs like statins to control cholesterol, anti-hypertensive agents to control blood pressure and other associated conditions like diabetes.

In regard to diet changes, people are asked not to eat foods that contain fat and too much salt and to exercise with the purpose of reducing high blood pressure.

Surgical treatment may include:

  • Invasive procedures for example percutaneous transluminal renal artery angioplasty namely opening of a renal artery by other means such as a balloon or by placing a stent in the artery which is a tiny, expandable metal coil that is inserted in an artery to keep it open.

Araujo calls for open surgery where the blocked renal artery is bypassed.

Renal vein thrombosis

Symptoms:

Slow onset:

  • In most cases there are no clinical signs and symptoms.

Sudden onset:

  • Severe flank pain that is not relieved persists with spasms at some point in time.
  • The skin of the kidney mentioned in the text sensitization between the ribs and the spine.
  • Decreased kidney function
  • Blood in urine

Treatment

Usually, treatment with an anticoagulant is administered to the patient, this prevents the clotting of blood in the body. They may be administered intravenously for 1- or 2-3 days periods and then orally for 5-7 days to weeks or longer.

What are potential consequences with renovascular diseases?

If neglected, renovascular diseases result in kidney failure. This might be treated by dialysis or a kidney transplant. Other complications include:

  • Heart disease
  • Stroke
  • Heart attack
  • Heart failure
  • Vasularity impairment
  • Vision loss

When does one seek his or her healthcare provider?

It is recommended to inform the healthcare provider if your symptoms become more severe or if you develop other symptoms.

Main aspects of renovascular diseases

  • Renovascular diseases comprise of diseases that affect the input or output blood supply to the kidneys.
  • Some risk factors are; Ageing, female gender, smoking and hypertension or diabetes.
  • There are diseases that hinder the flow of blood through the kidneys; and diseases that therefore determines the performance of the kidneys.
  • Potential consequences are heart disease, stroke, heart attack, and possibly vision problems. Chronic user of the substance can result to damage of the kidneys hence leading to kidney failure.
  • The treatment depends on the category of renovascular diseases that one has.

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