Blockage of the circulation to the kidneys is usually caused by atherosclerosis, or hardening of the arteries. In rare cases, primarily in women, a disease called fibromuscular dysplasia can cause a thickening of one of the layers of the artery wall. Either one of these conditions can reduce the blood supply to the kidneys causing high blood pressure that is difficult to control. If the blockage affects both kidneys, the function can deteriorate and renal failure may follow. The best method to diagnose this blockage is a noninvasive study, an MR angiogram. If there is evidence of significant blockage, a renal artery angioplasty is the usually best form of treatment. The results from angioplasty are nearly as good as surgery and certainly far less invasive. Renal artery surgery is occasionally necessary when the disease is associated with aneurysm of the artery or simultaneous surgery on the aorta is contemplated.
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