Normal Assessment from Nephrologist Despite Significant Findings
After experiencing uncontrolled hypertension, I was referred to a nephrologist. Not long ago, I was admitted to the hospital due to a condition known as PRES syndrome, which caused me to faint because of brain swelling linked to elevated blood pressure levels. Additionally, I have been diagnosed with Moyamoya disease, for which I underwent a surgical bypass (STA/MCA). A recent renal Doppler examination revealed notable right renal artery stenosis, indicating a blood flow velocity of 232, in contrast to the normal left side, which measured 120. The right kidney is also smaller, and I have been diagnosed with Fibromuscular dysplasia. Today, I received a call from the nephrologist's nurse, who informed me that the doctor deemed the scan results as "normal." When I inquired if he acknowledged the significant stenosis reading, she confirmed he did. However, he decided against a stent placement because my blood pressure is more manageable with medication—albeit an extensive regimen that has taken a toll on my well-being. Consequently, rather than proceeding with a 20-minute stenting operation that could improve blood flow to my kidney, he has opted to keep me on four different medications, which may continue to inflict damage on my kidneys. Can anyone help clarify this situation? As a 52-year-old nurse who generally leads an active and healthy lifestyle without diabetes, I find this decision troubling. I'm seriously contemplating seeking a second opinion and would appreciate any insights you may have.
Answers (1)
2/13/2026, 2:50:41 AM
OpenHealth AI
It sounds like you are facing a complex and concerning situation regarding your kidney health and hypertension management. Your worries about the nephrologist's assessment and treatment options are valid, especially given your medical history and the serious implications of conditions like PRES syndrome and Moyamoya disease.
Main Points
The nephrologist’s decision, despite significant findings, may stem from weighing the risks of intervention against your current medical management. However, if you feel that your health and quality of life are at risk, seeking a second opinion is a very reasonable and proactive step.
Explanation
The renal artery stenosis you've experienced—along with associated conditions like fibromuscular dysplasia—can certainly impact renal function and blood pressure control. Stenting is one potential intervention that can help improve blood flow and potentially stabilize or improve kidney function. If your nephrologist believes that medication is currently managing your blood pressure effectively and that the risks of stent placement outweigh the benefits, he may consider it a "normal" decision for now. However, your perspective as a nurse, combined with your symptoms and overall well-being, should carry significant weight in this decision-making process.
Next Steps
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Seek a Second Opinion: DO seek another opinion from a different nephrologist or a hypertension specialist. This can provide you with more clarity and potentially different treatment options based on your unique case.
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Document Your Symptoms: Keep a detailed record of your symptoms, medication side effects, and any changes in your health since starting your current treatment. This will be valuable information to share with any new healthcare provider.
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Discuss Concerns Openly: If you decide to follow up with your current nephrologist, express your concerns regarding the management plan and the impact of the medications on your daily life. A collaborative discussion may illuminate some options that haven't been considered.
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Focus on Lifestyle Factors: Continue maintaining your healthy lifestyle. Regular exercise, a balanced diet low in salt, and proper stress management can all help support your overall health and may assist in managing blood pressure.
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Monitor Your Health: Keep track of your blood pressure readings and any new symptoms that arise. If you notice significant changes, be proactive in discussing these with your healthcare provider.
Your health and peace of mind are paramount, so don’t hesitate to pursue whichever path will provide you with the reassurance and care you deserve. If you need further support or want to discuss your options, feel free to reach out.
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