Renal artery calcification (renal artery stenosis)

A Renal artery calcification, in technical terms too Renal artery stenosis called, is a type of hardening of the arteries in which one or both of the kidney arteries are narrowed. If left untreated, the disease can, in the worst case, lead to kidney failure and thus become life-threatening.

What is renal artery calcification?

Under one Renal artery calcification Doctors understand, as the name suggests, a calcification of the renal arteries. Either one or both arteries constricts, thereby impairing blood flow.

The calcification of the renal arteries can either be the trigger for further illnesses or it can occur as a secondary illness itself. Most of the time, renal artery stenosis is directly related to high blood pressure. It can either precede this or occur later as a consequence of the high blood pressure.

Heart disease can also be linked to calcification of the kidney arteries, especially coronary artery disease or arterial occlusive disease.

causes

According to statistics, the causes of a Renal artery calcification in approx. 80% of the cases a general calcification of the arteries in the body.

This is caused by deposits in the vessels, which are favored by an unhealthy lifestyle. If fat and cholesterol are consumed in large quantities and over a period of years, they are deposited on the inner walls of the vessels and thus lead to a slow narrowing. As a result of this, among other things, there is an increase in high blood pressure.

This process usually takes place in different places in the body and can also affect the renal arteries. Risk factors that promote hardening of the kidney arteries include diabetes, smoking, high cholesterol, lack of exercise and stress.

Symptoms; Complaints & signs

The renal artery calcification (renal artery stenosis) leads to a narrowing of the renal arteries and thus to an undersupply of the kidneys with blood. To prevent this, hormones are released that increase blood pressure. Therefore, the main symptom of renal artery calcification is initially high blood pressure.

At first, the renal artery stenosis goes unnoticed. Neither high blood pressure nor the narrowing of the renal arteries initially develop symptoms.Later on, non-specific symptoms such as dizziness, nausea, morning headaches, nervousness or visual disturbances can appear with high blood pressure. Sometimes so-called blood pressure crises also occur. The blood pressure crises are characterized by sudden phases of high blood pressure.

In these hypertensive phases, pulmonary edema, decreased exercise capacity and severe shortness of breath often occur. In the case of a blood pressure crisis, the second (diastolic) blood pressure value increases in isolation, while the first (systolic) blood pressure value remains unchanged. Due to the chronic high blood pressure and the constant high blood pressure crises, the kidney tissue is damaged in the long term up to renal insufficiency.

The affected kidney shrinks and forms a shrink kidney. To compensate for this, the healthy kidney enlarges. After that, all the symptoms of increasing kidney failure appear. After an initially increased urine excretion, the amount of urine excreted decreases in the later stages of kidney disease. In addition to fatigue and reduced performance, pain in the kidney area, headache, edema, excruciating itching, nausea, vomiting, bad breath of ammonia and much more occur.

Diagnosis & course

If you suspect Renal artery calcification the attending physician will first measure the blood pressure. A significantly increased diastolic value can indicate calcification. Additional blood and urine tests provide further information about the patient's state of health, as does an ultrasound of the kidney region.

A detailed discussion about the medical history and lifestyle can also help to make a diagnosis. A hissing noise may be heard when listening to the kidney region with the stethoscope. If calcification of the kidney arteries is detected early, it can usually be treated well before permanent kidney damage occurs. If renal artery stenosis has already occurred, the prognosis depends on the degree of damage.

Complications

Renal artery calcification (renal artery stenosis) can in most cases be treated well using various methods. However, if left untreated, the disease will progress. This can lead to numerous complications. Due to the narrowing of the renal arteries, the kidneys are initially undersupplied with blood. In order to ensure the normal blood supply, a signal is sent out, which causes a general increase in blood pressure in the body.

As a result, chronic high blood pressure develops. In addition, the renal artery can become completely blocked. As a result, chronic kidney failure requiring dialysis threatens. The detoxification of the blood can no longer take place sufficiently without regular blood washing. Urinary substances enter the blood, which can lead to a variety of damage to various organs.

In extreme cases, multiple organ failure with fatal outcome occurs. Chronic high blood pressure can also lead to many secondary diseases, which particularly affect the cardiovascular system. The risk of heart attacks or strokes increases. However, treatment of renal artery stenosis is not always successful.

In the case of fibromuscular renal artery stenosis, blood pressure normalizes in around 75 percent of cases. However, if it is caused by arteriosclerosis, it may sometimes not be successful. Furthermore, even after a successful operation, there is still a residual risk of re-occlusion of the blood vessel.

When should you go to the doctor?

Elevated blood pressure, gastrointestinal complaints and shortness of breath indicate calcification of the kidney arteries. Anyone who notices the symptoms described should consult a doctor. If the symptoms persist for more than two to three days or get worse within a short time, medical advice must be sought immediately. Calcification of the renal arteries can usually be treated well if it is detected early. The doctor will determine the condition on the basis of a physical examination and then initiate treatment.

People who have an unhealthy lifestyle or who suffer from kidney disease are at risk and need to discuss typical symptoms with their family doctor. People with hormonal or arterial problems should also consult a general practitioner. Other contact points are the nephrologist and other specialists for internal diseases. After the initial diagnosis by the specialist, further treatment is usually carried out by the family doctor. A hospital stay is only necessary for serious complications such as severe kidney pain or blood in the urine.

Treatment & Therapy

Does the attending physician have a Renal artery calcification If diagnosed, appropriate therapy must be initiated. In many cases, the disease can be treated quite well by widening the pathologically narrowed arteries.

This is done with the help of a balloon catheter, which is pushed through the bloodstream to the narrowed point. There a balloon is inflated so that the artery is widened again and blood can flow normally. It may be necessary that this procedure has to take place in several places or also repeatedly.

The arteries can narrow again relatively quickly, especially if the calcification of the kidney arteries is caused by permanently high blood pressure. If there is no improvement after this type of treatment, there is the option of performing a vascular operation in which a so-called bypass is placed. The narrowed artery can thus be bypassed and regular blood flow can be guaranteed again. The attending physician can also prescribe medication to lower blood pressure.

Here, however, the kidney function must be checked again and again, as the medication can have a negative effect on it. A healthy lifestyle also helps improve arterial condition and overall health and should therefore be followed to avoid the worsening of renal artery calcification.

Outlook & forecast

People with hardened kidney arteries are in a life-threatening condition. The general well-being deteriorates continuously until the organism collapses. Without medical care and medical supervision, the person concerned is at risk of sudden and premature death. Organ failure occurs, with ultimately no prospect of recovery. In acute cases, an emergency doctor must be called so that life-prolonging measures can be initiated.

For a good prognosis it is crucial that a diagnosis is made as soon as the first irregularities and health impairments appear. Medical treatment will then be initiated as soon as possible. This is the only way to avoid an emergency situation and optimize the blood supply.

In addition to organ failure of the kidneys, the affected person is also threatened with functional disorders of the heart. If there are other disorders of the circulatory system or cardiac activity, the prospect of recovery is negligible. Nevertheless, with early treatment, stabilization of the organism can be initiated so that the patient can continue to live. Long-term therapy and regular check-ups are necessary to achieve relief.

In many cases, the illness and the health impairments it triggers cause severe emotional stress. Psychological complications can occur and thus contribute to a further deterioration in general health.

prevention

Since the causes of a Renal artery calcification If in most cases there is general hardening of the arteries, a preventive measure is to minimize the risk factors significantly if possible. In this context, smoking should be stopped and excess weight should be reduced. A balanced diet that is reduced in fat has just as positive effects on the arteries as regular exercise. If illnesses such as diabetes, high cholesterol or high blood pressure already exist, these should definitely be treated so that calcification of the kidney arteries cannot develop in the first place.

Aftercare

After stent implantation, regular intake of anticoagulant medicine is necessary. A combination of aspirin (ASA) and clopidogrel (Plavix) is usually used for this. While the Plavix can usually be discontinued after several weeks, aspirin intake is usually recommended for a lifetime. The drug aspirin lowers the risk of cardiovascular disease. Another examination should be carried out in the vascular surgery outpatient clinic and in the kidney center approximately four weeks after the implantation.

In the course of the examination, the renal artery is checked and the laboratory values ​​are checked. Above all, the arterial blood pressure and kidney values ​​should be determined here. Further follow-up measures can be carried out by your family doctor or a kidney specialist. The follow-up examination should be carried out at regular intervals in order to be able to identify various functional disorders early.

If there is any suspicion of a renewed illness, further diagnostics should be carried out as soon as possible. As a rule, the cause of the renal artery stenosis can be successfully eliminated - provided that the disorder is recognized quickly and treatment is taken quickly. Because the longer the stenosis was untreated with high blood pressure, the lower the chance of a successful reduction in blood pressure. In addition, untreated renal artery stenosis is often associated with a gradual loss of function and shrinkage of the kidney.

You can do that yourself

Renal artery stenosis is often triggered by existing hardening of the arteries in the body, which in turn is caused by permanently high blood pressure. In order to reduce high blood pressure and thus the risk of further calcium deposits in the renal arteries, lifestyle changes are crucial in addition to medication.

To do this, it is important to reduce obesity and avoid high-fat and highly processed foods, especially those containing saturated fatty acids, as they raise dangerous LDL cholesterol levels. Saturated fatty acids are found in all animal products, but in large quantities especially in fast food, chips, pastries and confectionery. The menu should therefore be balanced and consist mainly of freshly prepared foods. Various studies have also shown the positive effects of red wine on blood vessels, although consumption should be limited to a maximum of two glasses per day.

If you already have calcification of the kidney arteries, it is also advisable to refrain from smoking and to be physically active. Sports such as swimming, cycling and Nordic walking make sense, but above all walks in the forest, as they not only positively support the cardiovascular system, but also have been shown to help reduce stress. Stress reduction can also be achieved through regular meditation, yoga, and adequate sleep.