Renal hypertension is the most common type of secondary hypertension. It’s caused by renal (kidney) disease. Lifestyle changes and medical treatments can help manage this condition.

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Hypertension — or high blood pressure — is a serious health condition affecting nearly half of all adults. Primary hypertension is the most common type of high blood pressure, but there are numerous kinds of secondary hypertension.

Secondary hypertension is when a particular cause can be identified. Renal hypertension affects the kidneys. Specifically, it’s when high blood pressure is due to the narrowing of arteries connected to the kidneys. Left untreated, it can lead to kidney failure.

Learn more about hypertension.

Renal hypertension is one of the most common types of secondary hypertension. It’s often caused by renal artery stenosis. This is a narrowing of one or both arteries that carries blood from the aorta to the kidneys.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that about 90% of renal artery stenosis cases are caused by atherosclerosis (a narrowing of arteries caused when a sticky substance, called plaque, builds up in your arteries).

You may have a higher chance of developing this condition if you have:

Your risk also goes up as you age.

Renal hypertension and renal artery stenosis often don’t have any symptoms until they become severe, according to NIDDK.

However, over time, your kidneys may decline.

Significant declines in kidney function may cause symptoms such as:

If you already have a history of vascular disease, you have an elevated risk of developing renal hypertension. If so, your doctor may want to keep a close eye on your blood pressure.


If a doctor suggests you may be developing renal hypertension, they will likely start by going over your medical history and performing a physical exam.

They may want to use a stethoscope on your abdomen to listen for sounds of narrowed arteries. However, the presence or absence of a whooshing sound of blood through a narrowed artery may not be enough to make or rule out a diagnosis.

Imaging tests may be necessary to diagnose renal hypertension. These tests may include:

  • duplex ultrasounds
  • computerized tomographic angiography (CTA) scans
  • catheter angiograms
  • magnetic resonance angiograms (MRA)

Treatment for renal hypertension

Once you receive a diagnosis, you’ll work with healthcare professionals to:

  • find the best treatments to lower your blood pressure
  • keep plaque from building up in your arteries
  • prevent new or additional kidney damage

Treatment is key because it can ward off the development of end-stage kidney failure. Your treatment options may include:

Lifestyle changes

Your doctor may start by recommending some lifestyle adjustments such as:


Your doctor may prescribe antihypertensive medications — medications that lower blood pressure and may slow the progression of kidney disease.

Two of the most effective types of medications for this include:

ACE inhibitors and ARBs are only prescribed for people who have one-sided renal artery stenosis. Typically, they may worsen the condition for anyone who has renal artery stenosis in both kidneys (bilateral). But ACE inhibitors may be prescribed for people with bilateral renal artery stenosis if they have a procedure to add stents to their renal arteries.

If either of these medications is not appropriate, a calcium channel blocker may be prescribed instead.

Angioplasty with stenting

Your doctor may suggest an angioplasty procedure to try opening up your arteries and holding them open with stents.

Renal bypass surgery

In renal bypass surgery, a new path is created to redirect the flow of blood into your kidneys while bypassing the blocked artery. However, surgery to treat renal hypertension is a much less commonly used treatment.

There are certain factors that may play a role in developing hypertension that you cannot change. This includes age, race, or family history.

But you can take certain steps to prevent developing high blood pressure. The best ways to prevent renal hypertension are through lifestyle improvements, like:

  • limiting your sodium, sugar, fats, and cholesterol to help reduce your chances of developing atherosclerosis
  • exercising regularly
  • maintaining a healthy weight for your body
  • stopping smoking
  • reducing or stopping drinking alcohol
  • reducing caffeine intake

If you already have high blood pressure, it’s important to take your blood pressure medications and work to keep your blood pressure managed. If you need help, you can reach out to a healthcare professional.

Renal hypertension is a common type of secondary hypertension. It’s typically caused by the narrowing of renal arteries. This is usually caused by atherosclerosis.

Lifestyle changes can help reduce your chances of developing renal hypertension. If your doctor believes you may have renal hypertension or have a higher risk, you can discuss lifestyle and treatment options available to you.