Renal artery stenosis (RAS) occurs when the arteries that carry blood to your kidneys narrow. It’s usually the result of atherosclerosis. Treatments include lifestyle changes, medication or surgery. RAS is a serious condition that can lead to chronic kidney disease or kidney failure.
Renal artery stenosis (RAS), or renal artery disease, is a narrowing of the arteries that carry blood from your heart to your kidneys. You have two renal arteries that supply blood to your right and left kidneys. One or both of these arteries can develop stenosis. Renal artery stenosis can lead to hypertension (high blood pressure), chronic kidney disease or kidney failure.
People with atherosclerosis are at the highest risk for renal artery stenosis. Atherosclerosis develops when plaque (a sticky substance mostly made of fat and cholesterol) builds up on artery walls. Risk factors for RAS include:
RAS affects the renal arteries that carry blood to your kidneys. Peripheral artery disease (PAD) affects the arteries that carry blood from your heart to your arms and legs. Atherosclerosis is usually the cause of both. Studies show that between 14% to 35% of people with PAD also have RAS.
Research also suggests that chronic kidney disease, which can result from RAS, may put people at a higher risk for PAD. People with both chronic kidney disease and PAD are at an increased risk of heart attack, stroke, limb loss and other serious health complications.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
In many cases, RAS doesn’t cause symptoms. It tends to cause problems, such as high blood pressure and reduced kidney function, only after the disease has progressed. Symptoms of poor kidney function may include:
Between 60% and 90% of RAS cases result from atherosclerosis. Fibromuscular dysplasia usually causes the remaining cases. Fibromuscular dysplasia occurs when there’s abnormal cell growth on artery walls, causing the arteries to narrow. It’s much more common in women and people AFAB — and it may result from genetics or hormones.
Potential complications of RAS include:
Sometimes, healthcare providers detect and diagnose renal artery stenosis incidentally. This means it happens during the process of diagnosing or treating another disease. If your healthcare provider suspects RAS, they may perform a variety of tests:
The most common treatments for RAS are lifestyle changes and medication. Surgery may be an option if someone develops severe stenosis in their renal arteries, is at risk of arterial occlusion (blockage), has unmanaged high blood pressure resistant to medications or has progressive loss of kidney function.
Your healthcare provider will likely recommend a variety of lifestyle changes to help manage RAS and lower high blood pressure, including:
Medication, combined with lifestyle changes, can help regulate high blood pressure and slow or prevent the progression of kidney disease. Your healthcare provider may recommend a combination of drugs:
Severe RAS not managed by medication may require surgery. The two main types of vascular surgeries for RAS include:
You can reduce your risk of RAS by:
Renal artery disease (RAS) is a progressive condition, worsening over time. The outlook for someone with RAS depends largely on the severity of the disease. Research shows that the four-year survival rate for people with renal artery blockage of 95% or more is only 48%. So, only about half of people with near-total artery occlusion survive for four years after diagnosis.
Contact a healthcare provider right away if you experience:
A note from Cleveland Clinic
Renal artery stenosis (RAS), or renal artery disease, occurs when the arteries that carry blood to your kidneys get too narrow. Atherosclerosis (plaque buildup in your arteries) is the most common cause. RAS can lead to serious health problems, including high blood pressure, chronic kidney disease or kidney failure. Lifestyle changes and medication are the most common treatments for RAS. In some cases, surgery is necessary.
Last reviewed by a Cleveland Clinic medical professional on 08/09/2022.
Learn more about our editorial process.