By Russell Becker, DO, Vascular Surgeon
End-Stage Renal Disease (ESRD) is a medical condition in which a person’s kidneys cease functioning on a permanent basis leading to the need for a regular course of long-term dialysis or a kidney transplant to maintain life. Cardiovascular disease is a major concern for patients with end-stage renal disease (ESRD), especially those on hemodialysis. ESRD patients with coronary artery disease often do not have symptoms or present with atypical symptoms. Coronary lesions in ESRD patients are characterized by increased media thickness, infiltration and activation of macrophages, and marked calcification.1
ESRD Risk Factors
• Smoking and other tobacco use
• Obesity
• Sedentary lifestyle
• High cholesterol
• High blood pressure (especially before age 30 or after 50)
• Diabetes
• Females have higher risk than males
• Family history of heart disease
Renal hypertension happens when the arteries that supply blood to the kidneys is narrowed and hardened due to atherosclerosis (plaque buildup) in one or both arteries connected to the kidneys. The arterial hardening causes insufficient blood flow to the kidney(s) and provokes the kidneys to overcompensate. When this happens, the kidneys respond as if the body is suffering from dehydration. In an effort to alleviate the dehydration, the kidneys produce a hormone that retains sodium and water in the body.
The reaction from the water and sodium retention causes the blood pressure to rise, in part, because the blood vessels also fill with the excess of fluids. If this condition is left untreated, the kidneys can no longer filter waste properly, will have restricted function, and eventually lead to chronic kidney disease. Unfortunately, there are usually little to no symptoms until the condition is advanced to the point of being critical.
However, your physician can perform a physical examination to listen to the arteries through a stethoscope; there are also blood and urine lab tests, and imaging such as Doppler ultrasound, CT, MRA, and renal arteriography to accurately diagnose the condition.
ESRD and Vascular Disease Treatment
Treatment for renal hypertension typically begins with hypertension medications like Ace Inhibitors, calcium channel blockers, diuretics, and ARBs. For advanced renal hypertension, a vascular surgeon can perform an angioplasty, place a stent(s) or a bypass vessel graft to open the artery and improve blood flow. If left untreated, high blood pressure can lead to strokes and heart attacks, while kidney disease can lead to fatal kidney failure.
Russell Becker, DO, Vascular Surgeon
Dr. Becker received his fellowship training in vascular and endovascular surgery at Wayne State University in Detroit. He is board-certified by the American Osteopathic Board of Surgery, he’s a fellow of the American College of Osteopathic Surgeons, and he retains active memberships with the Society for Vascular Surgery and the Florida Vascular Society.
Dr. Becker has experience and interest in all areas of vascular and endovascular surgery, including treatment of conditions like carotid artery disease, hemodialysis access creation and maintenance, and diseases of the veins.
Beyond performing surgery, Dr. Becker is a well published author of vascular surgery literature. He has previously served as an investigator in numerous new and developing clinical device trials and has been a part of the clinical faculty in vascular surgery at Michigan State University College of Human Medicine in East Lansing, Michigan.
Vascular Center of Naples
5490 Bryson Dr. Suite 201, Naples, FL 34109
239-431-5884
www.vascularcenternaples.com
Source: 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835444/