Renal insufficiency

Renal insufficiency is poor function of the kidneys that may be due to a reduction in blood-flow to the kidneys caused by renal artery disease. Normally, the kidneys regulate body fluid and blood pressure, as well as regulate blood chemistry and remove organic waste. Proper kidney function may be disrupted, however, when the arteries that provide the kidneys with blood become narrowed, a condition called renal artery stenosis. Some patients with renal insufficiency experience no symptoms or only mild symptoms. Others develop dangerously high blood pressure, poor kidney function, or kidney failure that requires dialysis.

Risk factors

The risk factors for renal insufficiency due to renal artery disease are those associated with atherosclerosis:

• Older age
• Gender
• Family history
• Race or ethnicity
• Genetic factors
• Hyperlipidemia (elevated fats in the blood)
• Hypertension (high blood pressure)
• Smoking
• Diabetes
• Obesity

Patients known to have atherosclerosis and diagnosed with coronary artery disease or peripheral artery disease are at greater risk for renal insufficiency.

Diagnosis

Renal artery disease can usually be diagnosed via duplex ultrasound scanning and other non-invasive tests. These include CT angiography and MR angiography. However, the definitive test is contrast angiography, a test that involves the injection of dye. If a severely blocked renal artery is discovered during an angiogram, treatment to open the artery may be performed during the same procedure.

Treatment

Patients with renal insufficiency who have mild or moderate symptoms can be treated with medication and monitored regularly through blood pressure measurements and blood tests to monitor kidney function. Those with severe renal insufficiency or symptoms, including renovascular hypertension.