Renal Artery Stenosis

renal artery stenosis

This 10 year-old boy presented with hypertension. A renal angiogram was performed which shows a tight stenosis of a right upper pole renal artery branch. There is post-stenotic dilatation of the affected vessel, and there are collaterals to the affected segment from surrounding normal arteries.

Renal artery stenosis is a cause of hypertension, as the affected segment excretes excessive renin in response to hypoperfusion. Renal artery stenosis is a common cause of paediatric hypertension. It is most often due to intimal, perimedial or adventitial fibrodysplasia, the narrowing usually being in the midportion of the main renal artery. Branch stenoses are however common. This condition must be discriminated from medial fibrodysplasia, which occurs in young adult women – the “string-of-beads” appearance typical of that disease is not seen.

Approximately one-third of cases of paediatric renal artery stenosis are associated with neurofibromatosis.

Reference: Silverman FN, Kuhn JP. Essentials of Caffey’s Paediatric X-Ray Diagnosis. Year Book Medical Publishers. 1990.

Credit: Dr Laughlin Dawes