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Renal artery stenosis (RAS) is the narrowing of one or both of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney , resulting in renovascular hypertension – a secondary type of high blood pressure .
This leads to a build-up of plaques and they can be deposited in the renal arteries causing stenosis and ischemic kidney disease. [citation needed] In this situation, the kidney supplied blood by the narrowed renal artery suffers from inadequate blood flow, which in turn causes the size of the kidneys to decrease. Other consequences include ...
Obstruction of the renal arteries supplying the kidney that result in elevated blood pressure is known as renovascular hypertension.It is thought that decreased perfusion of renal tissue due to stenosis of a main or branch renal artery activates the renin–angiotensin system.
Fibromuscular dysplasia (FMD) is a non-atherosclerotic, non-inflammatory disease of the blood vessels that causes abnormal growth within the wall of an artery. [1] FMD has been found in nearly every arterial bed in the body, although the most commonly affected are the renal and carotid arteries.
Angiotension converting enzyme. The pathogenesis of renovascular hypertension involves the narrowing of the arteries supplying the kidneys which causes a low perfusion pressure that is detected by the juxtaglomerular apparatus (via the macula densa cells, which act as baroreceptors; located on the afferent arteriole wall). [6]
The latter include renal artery stenosis, or the narrowing of the renal artery which supplies the kidney with blood, and renal vein thrombosis, which is the formation of a blood clot in the renal vein that drains blood from the kidney. [10]: 26-27
The captopril challenge test (CCT) is a non-invasive medical test that measures the change in renin plasma-levels in response to administration of captopril, an angiotensin converting enzyme inhibitor. It is used to assist in the diagnosis of renal artery stenosis.
Applying spectral Doppler to the renal artery and selected interlobular arteries, peak systolic velocities, resistive index, and acceleration curves can be estimated (Figure 4) (e.g., peak systolic velocity of the renal artery above 180 cm/s is a predictor of renal artery stenosis of more than 60%, and a resistive index, which is a calculated ...