Renal Hypertension: Symptoms, Diagnosis, and Treatment

Introduction

In the US, 75 million persons have high blood pressure, which is the cause of 8.6 percent of all primary care visits. One of the most typical causes of secondary hypertension is renal vascular hypertension, which frequently results in resistant hypertension. It is described as systemic hypertension that appears as a result of the kidneys' poor blood flow, which is often brought on by an occlusive lesion in the primary renal artery. In the term "renal hypertension," "renal" refers to the kidneys, and "hypertension" denotes high blood pressure. This illness develops as the arteries carrying blood to the kidneys shrink. Renal hypertension can result in heart attack, aneurysm, and stroke as complications.

What Is Renal Hypertension?

Renal hypertension, often referred to as renovascular hypertension, is a kind of high blood pressure brought on by the constriction or obstruction of the renal arteries, which carry blood to the kidneys. Reduced blood supply to the kidneys causes hormones that raise blood pressure to be released. A kind of secondary hypertension called renal hypertension results from an underlying ailment rather than being a main problem in and of itself. Atherosclerosis, a disorder where fatty deposits accumulate inside the walls of the renal arteries, commonly underlies renal hypertension and results in constriction or blockage of the arteries. Other, less frequent reasons include renal artery stenosis and fibromuscular dysplasia.

What Are the Symptoms of Renal Hypertension?

Renal hypertension sometimes begins without any obvious signs. But over time, having high blood pressure can cause symptoms like:

• Headaches.

• Dizziness.

• Distorted vision.

• Breathing difficulty.

• Chest discomfort.

• Fatigue.

Renal hypertension occasionally also results in signs of kidney injury or failure, such as:

• Legs, ankles, or foot swelling.

• Reduced urine production.

• Urine with blood in it.

• Elevated urine protein levels.

It is crucial to keep in mind that these symptoms might also be brought on by other illnesses, making a visit to a doctor necessary for a precise diagnosis.

What Are the Causes of Renal Hypertension?

Renal arteries, which feed blood to the kidneys, can constrict or get blocked, leading to renal hypertension. The disease known as atherosclerosis, in which fatty deposits accumulate inside the walls of the renal arteries and produce constriction or blockage, is the most frequent cause of renal hypertension. Infrequent causes of renal hypertension also include:

• Fibromuscular Dysplasia: The disorder known as fibromuscular dysplasia causes the walls of the renal arteries to thicken and narrow abnormally.

• Renal Artery Stenosis: A structural abnormality causes the renal artery to narrow, a condition is known as renal artery stenosis.

• Vasculitis: It is a disease in which the blood vessels constrict and become irritated.

• Tumors: Narrowing or blockage of the renal arteries may be brought on by tumors or other growths inside or near them.

• Blood Clots: When they develop in the renal arteries, blood clots can impede blood flow.

• Radiation Therapy: Radiation therapy used to treat cancer in the pelvis or abdomen can result in renal artery scarring and constriction.

• Medication: Some drugs, including birth control pills and hormone replacement treatment, can make renal artery constriction more likely.

How to Diagnose Renal Hypertension?

Diagnostic tests, a physical examination, and a medical history are frequently used to determine the presence of renal hypertension. The following are some of the most typical tests used to identify renal hypertension:

• Blood Testing: Blood tests are used to detect the amounts of several chemicals in the blood, including creatinine and electrolytes, which can assist in determining how well the kidneys are functioning.

• Urine Testing: Urine tests can assist in identifying the presence of protein or blood in the urine, which may be a symptom of kidney impairment.

• Imaging Procedures: Imaging procedures like ultrasound, CT scan, or MRI can help visualize the kidneys and the renal arteries and identify any narrowing, blockages, or anomalies.

• Angiography: Using X-rays to view the blood flow through the arteries, an angiogram is a more invasive treatment that requires injecting a contrast dye into the renal arteries.

• Ambulatory Blood Pressure Monitoring: A more precise picture of a person's blood pressure patterns can be obtained through ambulatory blood pressure monitoring, which entails wearing a device that continuously records blood pressure during the day and night.

• Renal Function Tests: Tests that determine how well the kidneys are working can be done, including ones that assess creatinine clearance.

How to Treat Renal Hypertension?

The underlying etiology and the degree of the illness determine the course of treatment for renal hypertension. Typical therapies include:

1. Drugs: Drugs can decrease blood pressure and lower the likelihood of problems. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), diuretics, and calcium channel blockers are a few examples of drugs used to treat renal hypertension.

2. Angioplasty and Stenting: During an angioplasty operation, a tiny balloon is inflated to expand a blocked or restricted renal artery and enhance blood flow. Stenting involves inserting a tiny metal mesh tube to keep the artery open.

3. Surgery: In extremely rare circumstances, surgery may be required to clear renal artery obstructions.

4. Lifestyle Changes: A balanced diet, keeping a healthy weight, giving up smoking, and engaging in regular exercise are all lifestyle choices that can lower blood pressure and enhance general health.

5. Control of Underlying Disorders: Renal hypertension can be improved by treating underlying conditions, including atherosclerosis, fibromuscular dysplasia, or vasculitis.

How Is the Prognosis?

The underlying cause of renal hypertension, the severity of the ailment, and how well it responds to therapy are some of the variables that affect the prognosis for the condition. The prognosis is often favorable if the underlying cause of renal hypertension is found and successfully addressed. However, if the condition is not treated or is not adequately managed, it can result in life-threatening complications. It is crucial to remember that renal hypertension is a chronic illness that calls for continuing care. Renal hypertension can sometimes worsen despite medication, necessitating further treatments, including angioplasty, stenting, or surgery. It is crucial to collaborate closely.

Conclusion

Diuretics, blood pressure-lowering drugs, and dietary and lifestyle modifications, including increasing exercise, are frequently used as treatment methods. Many patients with renal hypertension may regulate their blood pressure and avoid problems with the right care and medication. Working closely with a healthcare professional is crucial for managing renal hypertension and avoiding problems.