The mainstay of treatment for hypertension is medication to lower blood pressure. However, because of the consequences of renal hypertension, early diagnosis and additional treatment may provide the key to long-term control of hypertension and preservation of renal function. Several imaging studies are now available to evaluate the renal arteries and kidneys including duplex ultrasound, CT angiography and MR angiography. Each has its advantages and limitations, but all can be quite accurate in the detection of renal artery disease. When onset of hypertension is before age 30 or after age 50, or when stable hypertension becomes difficult to control with medication, renovascular hypertension should be suspected. These imaging tests should then be utilized to evaluate for possible renal artery disease.
Once diagnosed, treatment can be considered.. Balloon angioplasty and stent placement are usually the recommended treatment for renal artery disease. These are generally low-risk procedures, often performed on an outpatient or single night hospital stay basis. The goal of treatment is to normalize blood pressure and blood flow to the kidney, ultimately reducing hypertension and preserving kidney function. Fibromuscular disease is frequently cured by balloon angioplasty alone. Atherosclerotic disease often requires the placement of small stents for optimum results. Following treatment, it is imperative to follow the results both clinically with frequent blood pressure checks, as well as with follow-up imaging.