什么是肾血管疾病?

Renal vascular disease affects the blood flow into and out of the kidneys. It may cause kidney damage, kidney failure, and high 血压.

血管状况包括:

• 肾动脉狭窄(RAS). This is a narrowing or blockage of an 动脉 到肾脏s. 它可能会导致肾衰竭和高血压. 吸烟者患RAS的风险更大. 这在50到70岁的男性中最为常见. 高胆固醇, 糖尿病, 超重, and having a family history of heart disease are also risk factors for RAS. 高血压既是RAS的原因也是其结果.

• 肾动脉血栓形成. 这是一个血凝块 动脉 供应肾脏. 它可能会阻碍血液流动，导致肾衰竭.

• 肾静脉血栓形成. 这是血凝块的形成 vein 到肾脏.

• 肾动脉动脉瘤. This is a bulging, weak area in the wall of an 动脉 到肾脏. 大多数都很小，不会引起症状. 肾动脉动脉瘤s are rare and are often found during tests for other conditions.

• 动脉粥样硬化性肾病. This happens when a piece of plaque from a larger 动脉 breaks off and travels through the blood. 这会阻塞肾小动脉. This disease is becoming a common cause of kidney problems in the older adults.

肾素是一种能升高血压的强效激素. Decreased blood flow 到肾脏(s) from renal vascular disease may cause too much renin to be made. 这会导致高血压.

什么导致肾血管疾病?

The cause of renal vascular disease will depend on the specific condition involved. 主要原因有:

• 动脉粥样硬化

• 受伤

• 感染

• 炎症或其他潜在疾病

• 手术

• Tumor

• 动脉瘤

• 怀孕

• 某些药物

• 出生缺陷

哪些人有患肾血管疾病的风险?

肾血管疾病的危险因素包括:

• 老年

• 女

• 动脉粥样硬化

• 高血压, especially new high 血压 in an older person

• 吸烟

• 高胆固醇

• 糖尿病

肾血管疾病有哪些症状?

Symptoms of renal vascular disease vary depending on the type of disease and degree of involvement present.

肾动脉狭窄

• 高血压 that doesn’t get better with 3 or more medicines.

• Increased urea (a waste product made by the kidneys) in the blood.

• 原因不明的肾衰竭.

• Sudden kidney failure when first taking an angiotensin-converting enzyme (ACE) inhibitor for 血压 and/or heart treatment      

肾动脉血栓形成

• Sudden onset of side pain between the ribs and the upper border of the hip bone (flank pain), 疼痛和压痛

• Fever

• 尿中带血

• 恶心和呕吐

• 肾功能突然下降

• 高血压

A gradual or incomplete clot may not cause symptoms and go undetected

肾动脉动脉瘤

• 通常没有症状     

• 高血压

• Tear in aneurysms may cause flank pain and blood in the urine

动脉粥样硬化性肾病

• 皮肤病变或皮肤呈红色或紫色.

• 脚趾和脚的变色区域

• 肾功能衰竭

• 腹部疼痛

• 腹泻

• 混乱

• 减肥

• Fever

• 肌肉酸痛

肾静脉血栓形成

缓慢的开始

• 大多数情况下不会引起任何症状

突然发作

• 持续剧烈的腹部疼痛，有时伴有痉挛

• Soreness over the kidney, between the ribs and the backbone

• 肾功能减退

• 尿中带血    

The symptoms of renal vascular disease may look like other medical conditions or problems. Always talk with your healthcare provider for a diagnosis.

如何诊断肾血管疾病?

Your healthcare provider will review your medical history and do a physical exam. 其他测试可能包括:

• 动脉造影(或血管造影). This is an X-ray image of the blood vessels used to check for aneurysm, narrowing, or blockages. A dye (contrast) is injected through a thin, flexible tube placed in an 动脉. 这种染料使血管在x射线上可见.

• 双超声. This test is done to check blood flow and the structure of the renal veins and arteries. The term “duplex" refers to the fact that 2 modes of ultrasound are used. The first takes an image of the renal 动脉 being studied. 第二种模式检查血液流动.

• 肾图. This test is used to check the function and structure of the kidneys. 这是一种核放射学程序. This means that a tiny amount of a radioactive substance is used during the test to help view the kidneys.

• 磁共振血管造影(MRA). This test uses a combination of magnetic resonance imaging (MRI) technology and intravenous (IV) contrast dye to see blood vessels. Contrast dye causes blood vessels to appear solid on the MRI image. 这可以让医疗保健提供者看到血管.

肾血管病的治疗方法是什么?

Your healthcare provider will figure out the best treatment for you based on:

• 你多大了?

• 你的整体健康和病史

• 你病得有多严重?

• How well you can handle specific medicines, procedures, or therapies

• 这种情况预计会持续多久

• 你的意见或偏好

Treatment will also vary depending on the type of renal vascular disease that is present.

肾动脉狭窄

医疗

• Blood pressure lowering medicines other than ACE inhibitors may be used to treat high 血压.
• Medicines to lower cholesterol may be prescribed for atherosclerosis.
• Treatment of related medical conditions 比如糖尿病.

外科处置

• Endovascular procedures such as angioplasty (the opening of a renal 动脉 using a balloon or other method) or placement of a stent (a tiny, expandable metal coil placed inside an 动脉 to keep the 动脉 open).
• 开腹手术绕过阻塞的肾动脉.

肾动脉血栓形成

在急性病例中, thrombolytic (clot-busting) medicine may be infused into the renal 动脉 for several hours to several days to break up the clot.

手术 to remove the clot or bypass the 动脉 may be done in some situations.

肾动脉动脉瘤

Treatment of a renal 动脉 aneurysm depends on symptoms and the size and location of the aneurysm. Some smaller aneurysms may not be treated, but may be watched for growth or problems.

手术 may be used to treat larger, tearing, or growing aneurysms. It may also be used for aneurysms causing lack of blood flow 到肾脏 and high 血压, 动脉瘤会引起症状.

因为破裂的风险增加了。, a renal 动脉 aneurysm in a pregnant woman or a woman of childbearing age will generally be treated with surgery.

动脉粥样硬化性肾病

治疗可能包括降低胆固醇的药物, 血压, 并治疗其他相关疾病, 比如糖尿病.

通过饮食和运动来降低血压. 避免高脂肪和高盐的食物.

手术治疗包括:

• Endovascular procedures such as angioplasty (the opening of a renal 动脉 using a balloon or other method) or placement of a stent (a tiny, expandable metal coil placed inside an 动脉 to keep the 动脉 open).

• 开腹手术绕过阻塞的肾动脉.

肾静脉血栓形成

肾静脉血栓形成 is generally treated with an anticoagulant, 是什么阻止了血液凝结. They may be given intravenously (IV) for several days, then given by mouth for a few weeks or more.

肾血管疾病的并发症有哪些?

In time, renal vascular disease can lead to kidney failure. 这可能需要透析或肾移植. 其他并发症包括:

• 心脏病 

• 中风 

• 心脏病

• 心脏衰竭 

• 血管损伤

• 视力丧失

我应该什么时候给我的医疗保健提供者打电话?

If your symptoms get worse or you have new symptoms, tell your healthcare provider.

肾血管疾病要点

• Renal vascular disorders are a variety of conditions affecting the blood flow into or out of the kidneys.

• Conditions that affect the blood flow through the kidneys can affect the function of the kidneys and should be treated promptly to prevent permanent damage or other complications.