What it is
A narrowed renal artery reduces blood flow to the kidney, which responds by raising blood pressure (renovascular hypertension) and can lose function over time. Most cases come from plaque buildup; a minority — usually in younger women — are from fibromuscular dysplasia (FMD), a non-atherosclerotic narrowing that is often very treatable.
Why it matters
Risk Factors
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Blood pressure that stays high despite multiple medications.
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Worsening kidney function, especially after starting an ACE inhibitor or ARB.
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Sudden fluid buildup in the lungs (flash pulmonary edema).
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FMD clues — high blood pressure in a younger woman.
Diagnostic Testing
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Renal duplex ultrasound — non-invasive screening.
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CTA or MRA for detailed anatomy.
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Catheter angiography — definitive, and can treat in the same setting.
Treatment Options
Medical therapy
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First-line for most atherosclerotic disease:
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Blood-pressure control, often including a RAAS blocker (ACE inhibitor / ARB)
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A statin and antiplatelet therapy
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Risk-factor control and monitoring of kidney function
Invasive treatments
For selected patients — resistant hypertension, declining kidney function, flash pulmonary edema, or FMD:
We treat when it's likely to help, not reflexively.
Frequently asked questions
For referring providers — We welcome referrals for resistant hypertension, FMD, and renal artery stenosis with declining function or flash pulmonary edema. Refer: (918) 943-5303 · fax (855) 312-3594.
Refer urgently: flash pulmonary edema with suspected renal artery disease · Routinely: resistant hypertension, FMD, or progressive CKD with a suspected renal artery narrowing. Full referral guide →