Ischemic Nephropathy
Ischemia or ischemic health conditions indicate a lack of blood flow to a certain part of the body. Nephropathy is another way to say kidney disease. Ischemic nephropathy, therefore, is kidney disease caused by a lack of adequate blood flow. Though it is unknown how common ischemic nephropathy is, it is known to cause significant problems. If not properly managed, disease progression may lead to complications such as complete closure of kidney (renal) arteries and renal failure.
Symptoms
- Extreme high blood pressure accompanied with clogged arteries in men over age 60
- High blood pressure that comes on immediately, particularly among young patients and females
- High blood pressure combined with vascular bruit (audible sound caused by choppy blood flow)
Prevention
- Maintaining healthy blood pressure and cholesterol levels
- Proper management of diabetes and cardiovascular disease
Risk Factors
- Age (it becomes more common as you age)
- Atherosclerosis (clogged arteries)
- Diabetes
- High blood pressure
- Kidney disease (particularly renal failure)
- Sex (females are at higher risk)
Diagnosis
- Review of medical history and symptoms. A provider reviews your symptoms, lifestyle and medical history.
- Duplex doppler ultrasound. A special ultrasound is performed to give the provider a clear picture of your kidneys. The provider can see how narrow the kidneys’ blood vessels are (renal artery occlusion) as well as other kidney damage.
- Magnetic resonance angiography (MRA). Using magnets, radio waves and computer technology, MRA enables providers to evaluate blood vessels for renal artery disease. A contrast agent may be used for a clearer view of the vessels in and around the kidneys.
Treatment
- Medication. The minimum treatment for those with ischemic renal disease require a minimum of medication. When appropriate, medication to lower blood pressure is prescribed. In most cases, surgery is the primary treatment for ischemic nephropathy. When called upon, the gold standard is revascularization, which aims to provide lasting kidney vascular health improvement. Revascularization options include the following:
- Angioplasty. A tiny balloon is inserted in the clogged artery. When inflated, it presses the fat and cholesterol in the artery against the artery walls, leaving a wider path for blood to flow through.
- Bypass surgery. With this procedure, blood flow is rerouted to bypass the clogged section of artery, allowing improved blood flow and lowered blood pressure.
- Stent placement. A stent (a hollow mesh tube) is inserted in the narrowed kidney arteries. This allows increased blood to pass through the arteries and therefore reduces blood pressure. Stents are often inserted following angioplasty.
Follow-up Care
Whether medication or surgery is prescribed, a provider will monitor the effectiveness of the treatment for maximum benefit.
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