Renal arterial stenosis

[Cindy]

I am a 40 year old female who has recently been diagnosed with renal arterial stenosis. In July 1999 I developed hypertension which I have never had any previous problems with BP. Normal readings have been 90-120 over 50-70. I went on a diet and exercise program and lost 42 lbs. and the blood pressure appeared to drop for a few weeks. I should also mention that cholesterol was over 600 and triglycerides were over 800. I was put on Lipitor and Norvasc in July 1999. By November the weight was down, the cholesterol was 200 and the triglycerides were 480. But the blood pressure was out of control, fluctuating daily. I was having periods of dizziness and poluria but also was experiencing periorbital edema and pedal edema with fluctuating weight gain/loss of 7-10 lbs. in a few days period. I was sent for a renal artery and renal scan and was diagnosed with renal artery stenosis. My doctor is now on vacation for a few weeks and I am trying to find out just what all this means. My doctor felt an angiogram would be more beneficial. Please help!

[CCF CARDIO MD - DLB]

Insulin resistance could certainly be part of the problem. A nephrologist would look to see if the kidneys did show any signs of damage from diabetes or hypertension.

[ginny]

Dear Doctor,
Reading Cindy's post and her stated problems, it may be that Cindy is insulin resistant.  This would explain the high triglycerides and the renal artery stenosis.  This is known as Syndrome X(Not the same as the CAD Syndrome X.)and can cause Hypertension, Diabetes, Hypoglycemia, Peripheral Neuropathy, high triglycerides, and Arteriosclerosis.  In a woman, an apple shape as oppposed to a pear shape(a wider waist than hips)is the usual physical clue to this problem.  And Cindy's age is usually when women start experiencing hormone changes that also increase insulin resistance.  Could this explain Cindy's problems?
Sincerely,
Ginny

[CCF CARDIO MD - DLB]

Renal artery stenosis is a cause of high blood pressure that can be treated (usually with angioplasty). It can result in very high blood pressure; after angioplasty, the blood pressure is much easier to control with medications. The diagnosis can be suggested by an MRI or ultrasound, but is usually confirmed with an arteriogram. However, the periorbital and pedal edema are not typically associated with this condition. They can occur if the kidney is spilling protein. I think your next step should be to see a nephrologist, a kidney doctor, to sort out exactly what is going on with your kidneys.