An estimated 10-25 percent of the population is affected by hypertension, or high blood pressure. Of this group, a subset of 3 to 8 percent has hypertension caused by arterial blockage or narrowing of the renal artery, i.e., vascular disease. Decreased blood flow to the kidney is caused by renovascular disease. This decreased blood flow to the kidney results in systemic (body-wide) constriction of the blood vessels causing blood pressure to rise. Making it difficult to detect, the hypertension in the renal blood vessels may occur while the systemic blood pressure remains normal.
Renal Hypertension-A Major Cause of End-Stage Renal DiseaseIn the elderly, renal hypertension puts stress and increased pressure on the kidney causing chronic renal disease, or end-stage renal disease. Prevalent in the United States, atherosclerosis, or vascular disease, will increase in numbers as the population ages. This can also be said for the rise in cases of renovascular hypertension and end-stage renal disease. End-stage renal disease requires a person to receive dialysis or be placed on a list for a kidney transplant.
When the onset of hypertension occurs before age 30 or after age 50, renovascular hypertension should be suspected. It should also be suspected when stable hypertension becomes more difficult to control with medication. People over 50 and white males and blacks of both sexes have a higher risk of having renovascular hypertension.
Interventional radiologists can accurately diagnose renovascular disease with imaging studies and biochemical work-ups. Interventional radiologists can perform angioplasty and/or stenting to improve blood flow to the kidney if medical management-medications and lifestyle changes prove to be insufficient. In renovascular disease, the goal of treatment is to normalize the blood pressure or improve its control with medication and to improve or preserve kidney function. Being relatively low risk, angioplasty of the renal artery can greatly improve blood pressure and prevent further damage to the kidney. Replacing surgery, balloon angioplasty and stenting is the first-line of treatment for renal arterial occlusions.
Also playing a role in treating patients with renal failure are interventional radiologists. Revascularization with angioplasty has gained popularity as a treatment to improve or stabilize renal function. Of these patients, approximately 40 percent have seen an improvement. As awareness of the benefits and the relatively low risk of angioplasty becomes more understood in the medical community, the use of this treatment will more than likely increase.
In chronic renal failure, patients need regular hemodialysis to perform the kidney’s job of excreting toxic waste products from the body, to maintain acid-base balance, maintain electrolytes and fluid levels. These dialysis catheters perform a very important role of allowing long term dialysis until the peripheral AV Fistula matures. In certain cases, chronic diaysis catheters or permacaths are the only viable access site for long term dialysis. Thus saving and extending lives of many patients.
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