Are the arteries that carry blood to your kidneys narrowed? (Renal Artery Stenosis) Let's talk about this!

The kidneys are one of the most important organs in our body. They are like a filter that cleans the waste in our body. But sometimes, without us knowing, the main channels that supply blood to the kidneys, namely the renal arteries, can become blocked. This is what we medically call 'Renal Artery Stenosis' (RAS) or renal artery disease. This can be a serious condition, as it can lead to conditions like high blood pressure (hypertension) , chronic kidney disease (chronic kidney disease), and eventually kidney failure. So, it is very important to be aware of this.

Who is at higher risk of developing this disease?

Simply put, although this condition can develop in anyone, some people are at higher risk. People with atherosclerosis are particularly at risk. Atherosclerosis is a condition in which fatty substances such as cholesterol and plaque build up in the walls of our blood vessels, which can lead to blockages. Think of it like a water pipe becoming clogged with dirt over time.

So, if you have any of the risk factors below, it's a good idea to be a little more vigilant:

• If you have diabetes mellitus .
• If someone in the family has cardiovascular disease (that is, a hereditary link).
• If you have high blood pressure .
• If you have high blood cholesterol levels .
• Obesity means having too much body weight.
• The risk increases with age (men over 45 years old, women over 55 years old).
• Poor diet , meaning frequent consumption of foods high in salt, oil, and sugar.
• If you smoke , this is harmful for many things.

What is the relationship between renal artery stenosis and peripheral artery disease?

Here's another important thing. This renal artery stenosis (RAS) affects the arteries that carry blood to the kidneys. But there is another condition called 'Peripheral Artery Disease' (PAD) . In this, the arteries that carry blood from the heart to the arms and legs become blocked. Imagine, when you walk, you feel pain in your legs, and after a while you can walk again, you can see symptoms of this PAD.

The main cause of both RAS and PAD is often the aforementioned atherosclerosis . Studies have shown that between 14% and 35% of people with PAD may also have RAS. This means that there is a strong connection between the two.

Additionally, people with chronic kidney disease, which can be caused by RAS, have been found to be at an increased risk of developing PAD. A person with both conditions is at a much higher risk of developing serious health problems, such as heart attack, stroke, and loss of limbs . Therefore, it is important to be aware of these things.

What are the symptoms? How do we recognize this?

Often, this type of renal artery stenosis (RAS) does not show any symptoms in the early stages. It's like it's sneaking up on you and making the disease worse. Problems, such as high blood pressure and kidney failure, only start to appear when the disease is more severe. When the kidneys are not working properly, these symptoms can occur. See if you have any of these:

• Do you have difficulty concentrating or feel confused ?
• Can't sleep? (Difficulty sleeping)
• Are there any areas of your body that are swollen with water? (Edema), especially in the legs and ankles.
• Do you feel tired all the time ? Do you get tired even after doing a little work?
• Do you get headaches often ?
• Do you have a loss of appetite ?
• Do you experience muscle pain or cramps ?
• Do you have nausea and vomiting ?
• Do you experience shortness of breath (dyspnea) ? Do you feel short of breath even after walking for a short while?
• Skin changes - things like dry skin, itching, or darkening of the skin.
• Are you losing weight for no reason? (Unexplained weight loss)
• Are you urinating more or less often than usual?

Just because you have one or two of these symptoms doesn't mean you have the disease. However, if you have several of these symptoms, it's wise to seek medical advice.

Why do these renal arteries become blocked? What are the causes?

There are two main reasons for this.

1. To a large extent, between 60% and 90% of cases of RAS are caused by the condition we talked about earlier , atherosclerosis . This is the buildup of fatty deposits (plaque) on the walls of blood vessels, gradually narrowing them. This is the most common cause.

2. The remaining cases are often caused by a condition called 'Fibromuscular dysplasia' . This is a little different. This is where the cells in the artery walls grow abnormally and cause the arteries to become narrowed. This is not a fatty deposit. This condition is more common in women. It is thought to be caused by genetics or hormones.

What are the possible side effects (complications) of this?

Renal artery stenosis is not a simple condition. If it is not managed properly, it can lead to a number of other problems. For example:

• Chronic kidney disease: The gradual decline in kidney function.
• Coronary artery disease: Similar blockages can occur in the arteries that supply blood to the heart.
• Kidney atrophy: The size of the kidneys may decrease.
• Kidney failure: Eventually, the kidneys can stop working completely, requiring dialysis or a kidney transplant.
• Peripheral artery disease: Blockage of the arteries that carry blood to the limbs.
• Renal hypertension: High blood pressure in the renal arteries.

This is why it is very important to see a doctor immediately if you suspect a condition like this or have symptoms.

How is this disease accurately diagnosed?

Sometimes, doctors find renal artery stenosis incidentally. That is, when they are testing you for another condition. However, if your doctor suspects you have RAS, they may do some tests, such as:

• Physical exam: First, you will be examined thoroughly. Your blood pressure will be checked. In some people, this condition can cause uncontrollable high blood pressure. They will look for swelling in your limbs and listen to your breathing. The doctor may place a stethoscope over your kidneys to listen for blood gurgling. You may hear a 'whooshing' sound as blood flows through a blocked artery. The main sign of RAS is unexplained high blood pressure .
• Kidney function tests: Next, blood and urine tests are done to see how well your kidneys are working. These tests look for elevated levels of waste products like protein, creatinine , and nitrogen in your body. These are things that your kidneys need to filter out of your body. If they are elevated, it means your kidneys are not filtering waste products properly.
• Imaging scans: In addition, there are various types of imaging scans that can be used to see exactly how large your kidneys are and how well blood is flowing to them. These can also show how narrowed your arteries are. Your doctor may also recommend aYou may be asked to do a renal scan, duplex ultrasound, computerized tomographic angiography (CTA), or magnetic resonance angiogram (MRA) . These scans can provide a clear picture of the renal arteries.

What are the treatments for this?

The main treatments for this condition (RAS) are lifestyle changes and medications . Both should be used together. However, if the renal arteries are severely narrowed, there is a risk of arterial occlusion, if medication cannot control the pressure, or if kidney function continues to decline, surgery may be necessary.

How can this condition be controlled through lifestyle changes?

This is very important. Taking medication alone is not enough. Your doctor will definitely recommend some lifestyle changes that will help control this (RAS) condition and lower your high blood pressure. These are definitely things you should do:

• Eating a healthy diet: Eat foods that are low in fat, cholesterol, salt (sodium), and sugar. This means cutting back on fried rice, fried foods, sugary drinks, and fatty snacks. Include more home-grown vegetables, fruits, and nuts in your diet. Even small changes like these can make a big difference.
• Getting regular exercise: Do something like walking or cycling for at least 30 minutes a day. Exercise doesn't necessarily mean going to the gym.
• Losing weight: Try to maintain a weight that is appropriate for your height.
• Quitting smoking: If you smoke, stop immediately. This can be difficult, but there are ways to get help.

What help do medications provide?

Along with lifestyle changes, your doctor may prescribe several medications to help control high blood pressure and stop or control the progression of kidney disease. These should be used exactly as your doctor tells you.

• Medications like ACE inhibitors and Angiotensin Receptor Blockers (ARBs) block certain hormones that can constrict your blood vessels.
• Anticoagulants, such as aspirin , help blood flow through the veins more easily.
• Beta-blockers and calcium channel blockers, which reduce high blood pressure.
• Diuretics , also known as 'water pills', work by helping your kidneys remove excess water and salt from your body, lowering your blood pressure.
• Lowers blood cholesterol levelsStatins.

What kind of surgeries are there for this?

If the condition (RAS) is severe enough to be controlled by medication and lifestyle changes, such as when the artery is more than 70% blocked, surgery may be necessary. There are three main types of surgery:

1. Angioplasty and stenting: This is the most common procedure. In this procedure, the surgeon inserts a thin, flexible tube (catheter) into your blocked renal artery, either through your groin or arm. The catheter is then inflated with a small balloon at the end to widen the artery. A stent (a small mesh-like tube) is then placed in the artery to keep it from closing again and to allow blood to flow to the kidney. This is a minimally invasive procedure.

2. Renal artery bypass: This is a major operation. It's like a heart bypass. In this procedure, the surgeon creates a new path for blood to flow to the kidney, bypassing the blocked or blocked renal artery. This usually involves using a graft from your own leg or an artificial tube. This graft or tube is connected to an existing healthy artery, and the other end is connected to the blocked artery, halfway between the blocked artery and the kidney.

3. Renal endarterectomy: In this procedure, the surgeon opens the blocked renal artery and removes plaque and other material that is blocking blood flow.

Your doctor will decide which of these surgeries is right for you.

How do we protect ourselves from this disease? (Prevention)

"Prevention is better than cure," they say. So, here are some things you can do to reduce your risk of developing this (RAS) condition:

• Eat a balanced diet .
• Exercise regularly .
• Managing your blood pressure . Check your blood pressure regularly.
• Maintaining a healthy body weight .
• Don't smoke .

Doing these things will not only prevent kidney artery blockage, but it can also protect you from a host of other diseases.

What is the outlook for someone with this disease?

Renal artery disease (RAS) is a progressive condition that gets worse over time. The outlook for someone with this condition depends on the severity of the disease, how early it is diagnosed, and how well they respond to treatment.

Research has shown that only 48% of people with 95% or more blocked renal arteries have a four-year survival rate. That means that only half of people with almost complete blockages survive four years after diagnosis.Therefore, it is very important to recognize this condition early and seek treatment. If detected early, damage to the kidneys can be reduced and life expectancy can be extended.

When should I see a doctor about this?

If you have one or more of the following symptoms, see a doctor immediately . These may be signs of very low kidney function:

• If you feel a metallic taste in your mouth.
• If you have abdominal pain .
• If you have difficulty concentrating, confusion or problems concentrating .
• If the amount of urine output is very low (Low urine output) .
• If nausea and vomiting persist.
• If you have seizures .
• Swelling in your legs, arms or face .

Don't ignore these things. If you get treatment quickly, you can prevent major damage.

Finally, things you need to remember (Take-Home Message)

Renal Artery Stenosis (RAS) is a narrowing of the arteries that supply blood to the kidneys. The main cause of this is fatty deposits in the arteries (atherosclerosis) . This can lead to serious health problems such as high blood pressure, chronic kidney disease, and kidney failure.

Remember, this often doesn't show symptoms at first, but it can be dangerous if not treated properly.

Lifestyle changes (good diet, exercise, and quitting smoking) and medications prescribed by your doctor are the main treatments. In some cases, surgery may be necessary. Therefore, paying attention to symptoms, controlling risk factors if you have them, and seeking medical advice on time are very important to keep your kidneys healthy. Take care of your body, because health is the greatest asset!

` Renal Artery Stenosis, High Blood Pressure, Kidney Disease, Atherosclerosis, Arterial Stenosis, Kidney Health