What is Renal Hypertension?

High blood pressure (also called hypertension) affects 75 percent of American adults. Hypertension can be caused and affected by several diseases and conditions throughout the body, including kidney disease, pregnancy and tumors.

One condition, for example, is called renal hypertension, or renovascular hypertension. This refers to high blood pressure caused by kidney disease or kidney failure. Here are the basics of renal hypertension—its causes, symptoms and forms of treatment.

Causes

High blood pressure occurs when blood puts too much pressure on artery walls and weakens them. In cases of renal hypertension, the arteries delivering blood to the kidney become narrow, providing lower blood flow.

As a result of the low blood flow, the kidneys respond in the same way that they would respond to dehydration—releasing hormones that help the body retain more sodium and water. The blood vessels then fill with additional fluid, increasing blood pressure.

Most of the time, the narrowing of arteries is caused by atherosclerosis, or hardening of the arteries. It can also be caused by fibromuscular dysplasia, a condition in which arteries develop abnormally.

Symptoms

Like many cases of high blood pressure, renal hypertension often has no noticeable symptoms. This is part of what makes it difficult to recognize, and why blood pressure is such a big part of regular medical check ups. Those with severe renal hypertension may experience the following symptoms:

Headache and double vision
Blood in urine
Nosebleed
Confusion

Renal hypertension is dangerous because it can cause chronic kidney disease, a condition in which symptoms aren’t present until the condition has reached an advanced stage.

Treatment

Most cases of hypertension are initially treated using medications, and renal hypertension is no different. There are two medications that are most commonly used:

ACE inhibitors: Also known as angiotensin converting enzyme inhibitors, ACE inhibitors Include medications like amipril, benazepril and others.
ARBs: Short for angiotensin II receptor blockers, these include medications such as candesartan, losartan and valsartan.

Most cases of renal hypertension can be controlled with these medications, but some people will additional treatment. Depending on the specific case, treatment options include:

Angioplasty: In this procedure, a doctor inserts a catheter through the groin threads it to the renal artery. Then, a balloon in the catheter is inflated for a few seconds, widening the artery and improving the flow of blood.
Stenting: This is done during the same angioplasty procedure, and involves a wired stent that stays in the artery to hold it open after the catheter and balloon are removed. Most angioplasty procedures will also use stenting, as it’s usually more effective.
Surgery: This is usually only considered if angioplasty and stenting aren’t a possibility. During surgery, a doctor sews a healthy blood vessel next to the renal artery to bypass it. Similar procedures are sometimes done in the heart to treat coronary artery disease.

Some people need multiple procedures, and some treatments might be be less effective if both kidneys are affected. If you’re have high blood pressure or are at risk for renal hypertension, speak with your doctor for treatment options.