Renovascular hypertension

Renovascular hypertension
Renovascular hypertension is once again an elevation in blood pressure owing to partial or complete occlusion of renal arteries or even their branches. Generally, this is asymptomatic unless it is long-standing. You can hear a bruit over one or both renal arteries in nearly 50% of patients. This comes to knowledge by diagnosis and physical examination. The renal imaging with duplex ultrasonography, magnetic resonance angiography and radionuclide imaging describes the seriousness of renovascular hypertension. However, Angiography is done prior to definitive treatment with angioplasty or surgery. Renovascular disease is a common cause and can be cured. This is a curable hypertension. The occlusion of the renal arteries or any of these branches cause hypertension as they release rennin form the affected kidney’s juxta glomerular cells. The arterial lumen should be decreased before it causes hypertension. However, regardless of the reasons, renovascular hypertension is more in whites than among blacks. Nearly 2/3 of such cases are mainly caused by atherosclerosis and about 1/3 are due to fibro muscular dysplasia. The atherosclerosis is common in men above fifty and mainly affects 1/3 of the renal artery. Fibromuscular dysplasia is found among younger patients, especially women and affects 2 /3 of the prime renal artery as well as the renal arteries branches. Some rare causes include trauma, emboli, inadvertent legation during the process of surgery and compression of renal pedicle due to tumors. Renovascular hypertension is featured by intense cardiac output as well as due to elevated peripheral resistance. Initial identification using magnetic resonance angiography, ultrasonography or imaging is done to identify and to come into a conclusion for renovascular hypertension. This confirmation may also be therapeutic. If this is suspected, renal angiography proves it as the definitive test. The ultrasonography assesses the blood flow and is a noninvasive method for renal arteries. MRA is an accurate as well as noninvasive test for calculating the renal arteries. Even digital subtraction angiography done with specific injections particular for renal arteries also assures the diagnosis. The treatment deals with opening the renal artery with angioplasty and this relieves hypertension to a great extent. The elimination of affected kidney helps in the treatment of hypertension. Percutaneous transluminal angioplasty is suggested to be suitable for most patients. This includes the young patients as well. Some drugs are Bufferin, Genacote, Ecotrin and Plavix. Sometimes to rectify the renovascular hypertension the complete auto transplantation of kidney is suggested to cure.

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