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Urology (Expert Forum)
Renal Vascular Surgery
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Renal Vascular Surgery
by WINFRED, Jan 02, 2000 12:00AM
Is it possible for a person that has been on medication to control Blood Pressure for 30 years to have enough blockage in the arteries feeding the kidney to cause a very aggressive treatment to take place. At age 50 with bata blocker, diuratic, vasciodilators, and ACE inhibitors being increased 10 times over at age 55 to keep B/P under control. Or would this just be another part of primary high blood pressure.
Doctor's Answer
by HFHS M.D.-BL, Jan 02, 2000 12:00AM
Dear Winfred,
It is estimated that 5-10% of all hypertensive patients have renovascular hypertension. Renovascular hypertension is very difficult to manage medically, and even if adequate blood pressure control is achieved by medical means, progression of arterial disease is not prevented. Renovascular hypertension can be defined as a sustained blood pressure elevation secondary to a physiologically significant renal artery stenosis that is correctable by repair of the lesion or by removal of the kidney.
The evaluation of a patient with hypertension to determine if they have renovascular hypertension begins with a thorough history and physical. Occasionally a bruit (a distinctive sound heard with a stethoscope) can be heard over the renal artery. This is followed by a blood draw to measure the peripheral plasma renin levels and then a single dose captopril test. These two tests are non-invasive lab tests. After these two tests other more invasive tests such as collection of renal vein blood and arteriograms may be pursued. If a lesion is detected two basic options are available. Percutaneous angioplasty is used primarily for fibromuscular dysplasia and unilateral, non-occluded atherosclerotic renal artery stenoses. For most other lesions bypass surgery or placement of a renal artery stent is needed. Renovascular hypertension is a potentially curable disease, and it would certainly not hurt to discuss this with your physician.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BL
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It is estimated that 5-10% of all hypertensive patients have renovascular hypertension. Renovascular hypertension is very difficult to manage medically, and even if adequate blood pressure control is achieved by medical means, progression of arterial disease is not prevented. Renovascular hypertension can be defined as a sustained blood pressure elevation secondary to a physiologically significant renal artery stenosis that is correctable by repair of the lesion or by removal of the kidney.
The evaluation of a patient with hypertension to determine if they have renovascular hypertension begins with a thorough history and physical. Occasionally a bruit (a distinctive sound heard with a stethoscope) can be heard over the renal artery. This is followed by a blood draw to measure the peripheral plasma renin levels and then a single dose captopril test. These two tests are non-invasive lab tests. After these two tests other more invasive tests such as collection of renal vein blood and arteriograms may be pursued. If a lesion is detected two basic options are available. Percutaneous angioplasty is used primarily for fibromuscular dysplasia and unilateral, non-occluded atherosclerotic renal artery stenoses. For most other lesions bypass surgery or placement of a renal artery stent is needed. Renovascular hypertension is a potentially curable disease, and it would certainly not hurt to discuss this with your physician.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BL
*keyword
Member Comments
by rajeshgupta, Jul 23, 2000 12:00AM
To: Misc.
0
