Fast Facts

• Renal artery stenosis (RAS) is a narrowing of one or both of the blood vessels to the kidneys. RAS can lead to hard-to-control blood pressure.
• At this point, nobody knows whether the best way to treat RAS is with blood pressure pills or angioplasty (a procedure to open the blocked area).
• Medicines and angioplasty can both lower blood pressure for people who have RAS.
• A few people with RAS who have angioplasty can stop taking blood pressure pills. Most people will have to keep taking pills for their blood pressure, even after angioplasty.
• In the long run, there is no difference in how well the kidneys work for people who have angioplasty compared with people who just take blood pressure pills for RAS.

What does this guide cover?

This guide can help you talk with your doctor or nurse about treatments for renal artery stenosis (pronounced “steh-NO-sis”).

Renal artery stenosis (RAS) is a narrowing of one or both of the blood vessels (renal arteries) that carry blood to the kidneys. The kidneys help to control blood pressure. Narrowed renal arteries make it harder for the kidneys to work. RAS can get worse over time. It often leads to high blood pressure and kidney damage.

The information in this guide comes from a government-funded review of research about the treatment of RAS. It talks about:

• Health problems caused by RAS, like high blood pressure and kidney damage.
• Two kinds of treatment for RAS.

What is not covered by this guide?

• Who should be checked for RAS.
• The best test to find out if you have RAS.
• Whether lifestyle changes might help improve RAS.
• Surgery for RAS.
• A rare kind of RAS caused by fibromuscular dysplasia (a thickening of the artery walls).

Learning about renal artery stenosis

Treatments for renal artery stenosis

What are the risks of treatment?

All of the treatments have a risk of side effects. If you are thinking about treatment for RAS, talk with your doctor or nurse about your risk of any of these side effects or complications.

When will we know more?

A research study that is going on right now is looking at which treatment is best for RAS. We will have results in 2010. The research study is called Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL). It is funded by the National Institutes of Health. It involves two groups of people with RAS. One group of people will have angioplasty with stent and then will keep on taking pills to control their blood pressure. The other group of people will take pills to treat their high blood pressure without getting the angioplasty.

Visit this Web site to learn more about the CORAL research study: www.coralclinicaltrial.org/public/index.html

For more information

To get an electronic copy of this guide and materials about choosing treatments and medicines for other conditions, visit this Web site: www.effectivehealthcare.ahrq.gov

For a free print copy call:

The AHRQ Publications Clearinghouse, (800) 358-9295 Ask for AHRQ Publication Number: 07-EHC004-2A

For more information about renal artery stenosis, visit this Medline Plus Web site: www.nlm.nih.gov/medlineplus/ency/article/001273.htm

Source

The information in this guide comes from a detailed review of 56 research reports. The detailed review is called Comparative Effectiveness of Management Strategies for Renal Artery Stenosis (2006) and was written by the Tufts-New England Medical Center Evidence-based Practice Center.

The Agency for Healthcare Research and Quality (AHRQ) created the Eisenberg Center at Oregon Health & Science University to make research helpful for consumers. This guide was prepared by Sandra Robinson, M.S.P.H., Elizabeth Eckstrom, M.D., Martha Schechtel, R.N., and David Hickam, M.D. of the Eisenberg Center. People with high blood pressure helped them write this guide.