The Kidney Clinic

Resistant Hypertension /

Renal Artery Stenosis

Resistant hypertension is when the patient’s high blood pressure is not controlled with three or more anti-hypertensive medications. This condition will cause further narrowing of blood vessels around the kidneys, which leads to inadequate oxygen supply to the kidney tissues. As a result, the kidneys will get scarred and sustain permanent damage. Complications such as kidney failure, stroke, heart attack or failure, aneurysm in abdominal aorta and dementia may occur. 


Most people will not have symptoms. However, if the blood pressure is extremely high, a patient may suffer from headache, breathlessness, chest pain or leg swelling. 

Risk factors

Lifestyle choices including being a smoker, lack of physical activity, consuming high-salt diet, and excessive alcohol consumption are the major risk factors for hypertension.

Other factors include a family history of high blood pressure, chronic kidney disease, renal artery stenosis (narrowing in the arteries leading to the kidneys), adrenal or thyroid disorders and sleep apnoea.


Lupus nephritis

A chronic inflammatory disease, systemic lupus erythematosus can affect many parts of your body, including your skin, joints, kidneys, blood cells, heart and lungs.

Goodpasture's syndrome

In this rare disorder, also known as anti-GBM disease, the immune system creates antibodies to tissues in the lungs and kidneys. It can cause progressive and permanent damage to the kidneys.

Focal segmental glomerulosclerosis

In this condition, scarring is scattered among some of the glomeruli. This may be the result of another disease, or it may occur for no known reason.

IgA nephropathy

Immunoglobulin A (IgA) is an antibody that's a first line of defense against infectious agents. IgA nephropathy occurs when deposits of the antibody accumulate in the glomeruli.


such as cpolyarteritis nodosa, granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and Viral-associated glomerulonephritis (hepatitis B, hepatitis C and HIV virus).

Treatment Options

Further investigations are recommended and this includes a kidney health check and imaging of the major blood vessels leading to the kidney arteries. Adopting a healthy lifestyle is an integral part of lowering blood pressure. Anti-hypertensive medications that are personalised to the patient, enduring that they are taken appropriately including identifying side effects that may hamper the tolerability of these medications. Occasionally, intervention is required in blocked kidney arteries to help improve the blood pressure. 

Do you have a question about your kidney or medical condition?

Reach out to us for a consultation with Dr Alvin Ng. 

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