I had an MRI done of my kidneys on Tuesday and the doctor has told me I have Renal Artery Stenosis. The artery to my right kidney is "moderately narrowed."
He also told me this is the reason why my bp is so hard to control in spite of being on 3 different medications.
Does anyone know anything about Renal Artery Stenosis or Renal Vascular Hypertension?
If you haven't had one done, you should get a renal scan. In this exam they inject a small amount of radioactive tracer in your arm and then take images of your kidneys as they flush this tracer into your bladder.
MRIs and ulltrasounds can be misleading. I had both, which indicated my left kidney is enlarged and there is some narrowing of the tubes either in the kidney, or draining the kidney. Well, the renal scan showed that my left kidney is functioning as efficiently as the right one. In fact I was supposed to have lasix injected to work my kidneys harder, but they had already eliminated the tracer in the first test, so there was no point in the lasix part.
I had the renal scan at the time of the initial diagnosis, and then 6 months later, with the same result.
So while your blood pressure might be due to a kidney problem, you need a kidney function test (the renal scan), just to be sure you do have a kidney problem.
Thanks for your answer but I actually had an MRA and this was supposedly the best test to determine if there was any stenosis in the arteries. The test showed that both kidneys looked fine and were the right size.
The test was called:
MR Renal Angiography Without Contrast and With Contrast. ( I don't know what the difference is between an MRI and this test.)
Here is the official report:
Impression:
Single renal arteries bilaterally.
Short segment moderate stenosis in the right proximal renal artery, approximately 1cm from it's origin.
Patent left renal artery.
I have to go back to the kidney doctor on 3/21 and I will ask him about the renal scan. I did have an allergic reaction to the contrast that was used so I'm a little scared now to have any kind of contrast. I've had it in the past though and never had any reactions to it but the doctor said it could have been because of the beta-blocker I'm on. (Metoprolol 50mg 2x a day)
I was diagnosed 3 years ago with renal artery stenosis after having doppler study, then apparently what you call a renal scan (in nuclear medicine), &
finally renal angiography of arteriogram ( cath is inserted in artery in leg by radiologist). The first test (doppler) indicated one kidney was much smaller than
other (and believe I was told a difference in size of 3 cm or more indicates a
problem which was probably contributing to the BP problem I was having)..
During the arteriogram, the actual size of the kidney was measured and also
a sample of the "renin hormone" the kidney produces was taken.. Two of my
doctors explained in layman's terms that when the kidney is non-functioning or
less than it needs to, the bad kidney produces excess amounts of this hormone in an effort to make the kidney function better, and this hormone
causes the BP to elevate uncontrollably..
If there is partial blockage there, a stent can be inserted
for better blood flow thru the renal artery.. If not as in my case, if the artery is totally blocked, the meds I am given (primarily Ace inhibitors) control this
hormone better than the meds I was on for years which were not controlling
the BP at all apparently ..
Also, the renal doctor checks all the blood levels as well as kidney function
blood levels every few months, and is really my best advisor as to what drugs, even OTC meds to avoid that are hard on the kidneys.. There are lots one has
to avoid if a problem is suspected..
Hope your nephrologist is as thorough as mine has been..
Thanks everyonefor the information. Thankfully the stenosis is not that bad that it is affecting the size of my kidneys. Maybe it was caught early. I'm not going to worry about it and I'm not going to go for any further tests. I'm tired of all the tests and all the medications.
Each time I go for a test and something comes back abnormal there's always a reason for it. My renein levels were very high but that was due to the medication I was on and now the MRA I had done showed renal stenosis but apparently that test was not reliable either.
I had a bad reaction to the contrast so I know for a fact that I will not be going for any more tests. It seems as though it's not body that's making me hypertensive so therefore it must be my imagination.
Tomorrow morning I am going to let the toilet take my pills. The diuretic is making me dehydrated and I'm losing magnesium, the beta-blocker has me feeling tired and depressed all the time and the Diovan is giving me headaches. I personally think the cure is worse than the disease.
I've had uncontrolled high blood pressure since I was 23 and I'm 49 now and so far there's no damage to my heart or kidneys so therefore I will probably last another 28 yrs with it uncontrolled.
As of right now I'm a little disgusted with it all. For every test result I get back there's a reason for it and I'm told it's not a problem so therefore if there's no problem then I'm not wasting any more of my time going for any more tests and doctors and I'm not going to waste my insurance company's money.
