Renal Artery Stenosis

Question 1

What is a common cause of renal pathology.

Answer 1

Hypertension.

Question 2

What are some renal conditions that can cause hypertension. (5)

Answer 2

Diabetic nephropathy. 
Glomerulonephritis. 
Chronic interstitial nephritis. 
Polycystic kidneys. 
Renovascular disease.

Question 3

What is renovascular disease.

Answer 3

It is stenosis of the renal artery or one of its branches.

Question 4

What are some causes of renovascular disease. (7)

Answer 4

Atherosclerosis (in 80% >50years arthropathies often coexist: IHD, stroke, peripheral vascular disease).
Fibromuscular dysplasia (10%, usually young women).
Takayasu’s arteritis.
Antiphospholipid syndrome.
Post-renal transplant.
Thromboembolism.
External compression.

Question 5

What are the signs of renovascular disease. (5)

Answer 5

Raised BP resistant to treatment.
Worsening renal function after ACEi/ARB in bilateral renal artery stenosis.
‘Flash’ pulmonary oedema (sudden onset, without LV impairment on cardiac echo).
Abdominal and carotid or femoral bruits.
Weak leg pulses.