Hypertension / Renal artery Stenosis

[Andy0908]

My girlfriend is 26 years old. She has been diagnosed with RenoVascular Hypertension. Last reading was 160/110. There were absolutely no symptoms. She is healthy and has healthy food habits and no smoking/alcohol addiction. The tests showed there is narrowing/blockage of one renal artery causing insufficient blood flow in one of the kidneys.

Her creatinin level is normal. Kidney apparently is also in a functioning state. There is no adrenaline imbalance or problem in glands.

I am scared about her future. Is this curable permanently by medication or surgery ? Does she have to take hyper tension medication life long ? Will it impact pregnancy ? Overall will there be chances of kidney/heart failures ? She has been given a hyper tension medicine, a calcium blocker called "Eslo". Is there side effects to using this kind of medication for long term?

Also is this disease genetic ? I was planning to propose to her. She has hidden this condition from me so far. Now I want to help her but I do not know what I should do about living my life with her with such a condition.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament.
People live a normal life with just one kidney. Her kidney function tests should help assess the present functioning of her kidneys. Also, take precautions against urinary tract infections, it is worthwhile doing a urine culture in order not to miss chronic infection of the urinary tract. Some of the chronic infections such as tuberculous kidney may require (IVU / IVP) intravenous pyelography / urography for diagnosis (as well as urine culture for tubercle bacilli). If her kidney functioning is adequate and there is no evidence of infection, you could just follow up with your doctor at regular intervals.

Hope this helped and do keep us posted.

[Andy0908]

Thanks for your answer.

The doctors did more tests and the final report says, she has multiple focal cortical scarring on both her kidneys(more on left) which was possibly caused by undetected Urinary tract infection. This has resulted in significant loss of parenchymal enhancement.
On top of that, she also has occlusion in upper pole renal artery to the left.

They ruled out renal artery stenosis & FMD.

Current situation says, upper half of left kidney is not getting any blood flow. Right kidney has started compensating. Left kidney measures 6.2 cm long, right kidney 9.4 cm.

They have prescribed lifelong hypertension medicine(calcium blocker) and saying that she should be having a close to normal life with this medicine & healthy lifestyle.

I am worried on whether the situation can deteriorate in an average case. As per the doctors she wont need transplant anytime soon, and its possible to live normal life with just 1 kidney, however she has scars(less on right) in both the kidneys.

I wanted to assess the long term risks.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament.
Renal artery stenosis is usually due to atherosclerosis due to aging. But there is a genetic risk of Renal artery stenosis. If untreated it can progress to renal failure. Surgical management is considered for >80% bilateral stenosis and stenosis in a solitary functioning kidney. This is correlated with blood creatinine levels to assess the renal function. So, based on the degree of stenosis and the renal functioning surgical therapy is planned and the outcome is good. Please discuss the various possibilities with your doctor.

Hope this helped and do keep us posted.