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Old 12-04-2003, 09:18 PM   #1
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diitto HB User
Renal Artery Stenosis Confirmed...

Hi... I recently had an MRA (Magnetic Resonance Angiogram, an MRI with Gadolinium based dye injected to highlight arteries) and just today got the expected results... I have a "severe stenosis at the origin of the right renal artery". The symptoms that started the path to this diagnosis was rapid onset, very high blood pressure (220/135) which was followed by a renal ultrasound that demonstrated a small right kidney... Rapid onset high blood pressure and a small kidney often indicates Renal Artery Stenosis.

The blood pressure is controlled today as it has been for some time... The left kidney function appears to be good... The right kidney has some function though how much is not clear. I am about to do a differential renal function scan which I was told is a radioactive tracer dye inject via IV into the arm with subsequent monitoring with a Geiger counter type device over each kidney to determine how much of the material passes through which kidney or something like that... It would appear that whatever that shows, the nephrologist still wants me to go do angioplasty to attempt to open the artery and leave behind a metal stent...

Now here is my big question. The Iodine dyes they use for highlighting the arteries in this angioplasty procedure are TOXIC to the KIDNEYS and can bring about RENAL FAILURE!!!! Now, I am struggling with that... I am already struggling with one bad kidney and they want me to put the other one at risk???!!!!

Now, years ago I had a Cat scan of another body area and I had a contrast dye injected then. I am assuming that too was Iodine (10 years ago) and I had no problem with that... Would that be an indicator that I could handle iodine again or is this different because I now have one marginal kidney and one (the good one) that is only now recovering from getting blasted by very high blood pressure back in August?? My creatinine is just now back in the normal range (1.2 mg/dL now) although it was never horribly high with 1.5 mg/dL being the highest it got.

And has anyone heard of using alternate dyes for this procedure?? One x-ray tech told me he believes they can also use a gadolinium based dye similar to what I had in my recent MRA?? That I haven't seen mentioned anywhere on the web so likely that information was bogus...

Does anyone have any knowledge about the likelihood of bringing on kidney failure of my good kidney while trying to save the other one due to a reaction to these Iodine based dyes?? Any help would be much appreciated...

thanks... diitto....

 
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Old 01-11-2008, 02:50 PM   #2
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Re: Renal Artery Stenosis Confirmed...

Quote:
Originally Posted by diitto View Post
Hi... I recently had an MRA (Magnetic Resonance Angiogram, an MRI with Gadolinium based dye injected to highlight arteries) and just today got the expected results... I have a "severe stenosis at the origin of the right renal artery". The symptoms that started the path to this diagnosis was rapid onset, very high blood pressure (220/135) which was followed by a renal ultrasound that demonstrated a small right kidney... Rapid onset high blood pressure and a small kidney often indicates Renal Artery Stenosis.

The blood pressure is controlled today as it has been for some time... The left kidney function appears to be good... The right kidney has some function though how much is not clear. I am about to do a differential renal function scan which I was told is a radioactive tracer dye inject via IV into the arm with subsequent monitoring with a Geiger counter type device over each kidney to determine how much of the material passes through which kidney or something like that... It would appear that whatever that shows, the nephrologist still wants me to go do angioplasty to attempt to open the artery and leave behind a metal stent...

Now here is my big question. The Iodine dyes they use for highlighting the arteries in this angioplasty procedure are TOXIC to the KIDNEYS and can bring about RENAL FAILURE!!!! Now, I am struggling with that... I am already struggling with one bad kidney and they want me to put the other one at risk???!!!!

Now, years ago I had a Cat scan of another body area and I had a contrast dye injected then. I am assuming that too was Iodine (10 years ago) and I had no problem with that... Would that be an indicator that I could handle iodine again or is this different because I now have one marginal kidney and one (the good one) that is only now recovering from getting blasted by very high blood pressure back in August?? My creatinine is just now back in the normal range (1.2 mg/dL now) although it was never horribly high with 1.5 mg/dL being the highest it got.

And has anyone heard of using alternate dyes for this procedure?? One x-ray tech told me he believes they can also use a gadolinium based dye similar to what I had in my recent MRA?? That I haven't seen mentioned anywhere on the web so likely that information was bogus...

Does anyone have any knowledge about the likelihood of bringing on kidney failure of my good kidney while trying to save the other one due to a reaction to these Iodine based dyes?? Any help would be much appreciated...

thanks... diitto....
don't let them give you the MRI dye, it contains gadolinium. if you have any level of renal insufficiency when receive an MRI w/ contrast, you are at risk for developing Nephrogenic Systemic Fibrosis - an incurable disease for which there is presently no known effective treatment.

 
Old 01-18-2008, 08:56 AM   #3
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Re: Renal Artery Stenosis Confirmed...

Quote:
Originally Posted by will8427 View Post
don't let them give you the MRI dye, it contains gadolinium. if you have any level of renal insufficiency when receive an MRI w/ contrast, you are at risk for developing Nephrogenic Systemic Fibrosis - an incurable disease for which there is presently no known effective treatment.
My mother had an angiogram and had a cypher stent placed in her right artery which was 95% blocked. She developed a severe rash the next day where she looked sunburned, especially on her back, ankles, wrists, and inside of fingers- the "hotspots" I would say. She had itching and they gave her benadryl. It took almost 2 weeks for it to go away. She was also on steriods for the last 3 days of her hospital stay. She peeled from her neck to her toes. Nothing on her face. I've read about NSF and am concerned that if it had that much affect on her outside - what happened to her inside? Doctors never did 'pinpoint' what caused the reaction. I read that it could be the med on the stent, the polymer on the stent, the dye, and plavix - any one of them could cause this reaction.

She is fine now, but like I said, what happened inside I don't know. Her fingernail beds are indented now and they never used to be.
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Old 01-19-2008, 12:00 AM   #4
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Re: Renal Artery Stenosis Confirmed...

I am not sure what types of dyes they use in the tests you are about to have. I have kidney disease with reduced kidney function and had angiograms done. The reason they always run blood and urine tests before the procedure is to determine the level of kidney function. If it is reasonably good, they use a cheaper dye. If reduced, they use a costly dye that is not as harsh on the kidneys. There is a risk or renal failure from the use of dyes, as you know. I guess the risk of damage to the kidneys rises with decline in kidney function.

 
Old 01-19-2008, 07:42 AM   #5
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Re: Renal Artery Stenosis Confirmed...

I also wanted to let you know that they took extra precautions due to her kidney disease. They gave her lots of intravenous fluids before and after to help flush the kidneys.
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