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Suggest Treatment For Renal Artery Stenosis

Posted on Mon, 8 Jun 2015

Question: my father have pain in the kidney. attached is the initial test reports. can you please suggest the next steps? what are the tests we should take now and who is the best dr. in XXXXXXX for this? i heard psri is the best place for the kidney problems?

Answered by Dr. Rakesh Madhyastha (1 hour later)

Brief Answer:
Left renal arterty stenosis

Detailed Answer:
Hello

Thanks for the query

It looks like your father is suffering from left renal artery stenosis. Which means that the blood flow to the kidney has reduced significantly. Here is how you should go about it

1. Get a DTPA renal scan to know the functioning of the left kidney
2. If the functioning of the kidney is normal or salvageable after the DTPA scan then you will have to go for stenting of the artery
3. Stenting of the artery is done by cardiologist after a angiogram.

I recommend you to approach Dr Alkhil XXXXXXX of Apollo Hospitals for one stop solution for the problem.

I hope I was of help, if you have any further questions please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (2 days later)

i have attached couple of more tests done. can you please suggest what is ur opinion in this case?

Answered by Dr. Rakesh Madhyastha (4 hours later)

Brief Answer:
Single functioning kidney

Detailed Answer:
Hello

Thanks for getting back with the reports. From the reports I infer that the left kidney is not functioning anymore. If I were to be your doctor I would not do anything about it.
I would do the following things

1. Get serum creatinine and potassium done. Based on that I would add an ace/arb tablet for protection of the right kidney
2. Avoid analgesics or herbal medicines known to cause kidney injury
3. Exercise daily for atleast 45 min a day
4. get renal function test done once in 6 months

I hope I was of help, if you have any further queries please do get back

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (13 hours later)

left kidney is still at 20% as per reports so should we just let it die? will it cause any problem in future.
also the pain that my father is having sometimes it increases to unbearable level. what should we do about it?
also my father have a high blood pressure. do the kidney problem arises due to high blood pressure or its the reverse?

Answered by Dr. Rakesh Madhyastha (6 hours later)

Brief Answer:
Follow up

Detailed Answer:
Hello

You have asked a very good question.
The idea of doing a renal artery stenting for a kidney is to salvage that kidney. Usually in early phase of detection of renal artery stenosis the functioning of the kidney will be good and the size of the kidney will be normal or slightly reduced in size,in such cases it makes sense doing an intervention. Once the kidney is already shrunken and the functioning of the kidney is less there is not point. Left kidney will not die, functioning of the left kidney has reached a stage where it has got adjusted to the reduced blood supply through the stenosed artery. It will not improve further after stenting.

The high blood pressure is due the renal impairment. Adding ACE/ARB and centrally acting antihypertensives like Arkamin will be of help, it will bring down the blood pressure well.

Pain might not be to the stenosis. I suggest getting a surgical opinion for the pain. The best painkiller for your father would be tramadol.

I hope I was of help, please get back to me for any further doubts please get back to me

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Rakesh Madhyastha (1 hour later)

thanks for the reply !
can you please suggest any good surgical doctor in XXXXXXX from where we can take help?

Answered by Dr. Rakesh Madhyastha (30 minutes later)

Brief Answer:
Follow up

Detailed Answer:
Hello

I don't know any surgeon in XXXXXXX myself however if you can tell me which part of XXXXXXX I can ask my surgeon colleagues and find out for you.
You can also search for a surgeon in XXXXXXX through Healthcaremagic 'search for a doctor' link

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar