Vascular disease, or atherosclerosis, is a process that occurs over several years. If the plaque level builds up in the artery to such a degree that the narrowing is significant, the kidneys may not receive the blood they need and the kidney function can be affected. When this happens, many people will feel and appear perfectly normal. Some, however, may show certain signs and symptoms due to the significant narrowing in the artery.
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One such sign is blood pressure that just won't stay down. If you are on more than three medications for high blood pressure and your doctor is having a difficult time regulating it, he may begin to suspect that there is a problem with the blood flow to your kidneys. Another sign is recurrent heart failure. If you have developed a buildup of fluid in your lungs and your doctor says your heart is fine, he may suspect that you have problems with the blood flow to your kidneys.
After starting on an ACE inhibitor, your doctor may ask you to have follow-up blood work done a week or so later. If your kidney function suddenly gets worse or if your potassium level increases, that can also be a tip-off that you have problems with the circulation to your kidneys.
Those at Risk for Vascular Disease in the Kidneys
Patients with diabetes are at a higher risk for vascular disease in the kidneys. Those with evidence of circulation problems in other areas of the body - carotid, coronary, or peripheral vascular disease - are also at risk. In addition, elevated homocysteine (homo-sis-teen) levels may increase the risk of developing vascular disease. Homocysteine is an amino acid, and it is thought that high levels in the blood may be a risk factor for atherosclerosis. This can be measured by a simple blood test. High cholesterol and high triglycerides are also risk factors. inflammation also can increase the rate of atherosclerosis, your doctor may order a blood test called a sedimentation (said-dub-men-tashe-un) rate, or he may choose to order a C-reactive protein, because they can indicate the level of inflammation in the body.
Standard Treatment Approaches
The initial evaluation and management of vascular disease of the kidney still remains somewhat of a gray area. There are several different options concerning imaging studies to better look at the blood flow to the kidneys. Each type of study, as you will see, is not without its limitations or potential adverse effects. Likewise, the treatment for severe stenosis is not without its potential problems. The treatment plan is often individualized for each person, depending on age, signs and symptoms present, other medical conditions, and viability of the kidneys.
Diagnostic: Imaging Studies Your Doctor May Order
If your doctor suspects a problem with the blood flow to your kidneys, she may order a special type of ultrasound, called a Doppler ultrasound. This commonly ordered imaging test can give an indication of how well the blood is flowing to your kidneys. If the Doppler ultrasound suggests that there is a significant narrowing of the artery, then your doctor may opt to order another type of imaging test, including an MRI or a special type of CAT scan.
If you have an increased BMI, your doctor may suggest obtaining an MRI or a CAT scan as a first line imaging study, as the Doppler ultrasound may not provide enough diagnostic information. These studies are not without their inherent risks. Your doctor may also refer you to a vascular surgeon for a consultation. To find out more, you can check out Feline Kidney Disease Treatment.