What is renal angioplasty and stenting? 

Renal angioplasty is a procedure to open a narrowed kidney artery. It is sometimes carried out at the same time as a renal angiogram, a test that checks whether the blood vessels that supply the kidneys (the renal arteries) have become narrowed.

If narrowing is seen, you may have an angioplasty to clear the blockage.

If the two procedures are carried out at the same time, it is known as a renal angiogram with angioplasty.

Sometimes the angioplasty is carried out by itself after a renal angiogram.

A renal angioplasty is a day procedure carried out in hospital under local anaesthetic.

What does a renal angioplasty involve?

A thin plastic tube called a catheter is inserted into your artery using a needle. This is usually through an artery in your groin and contrast dye is passed through it to highlight narrowed areas.

If narrowing is confirmed, a catheter with a balloon on the end is inserted, and the balloon is inflated to open the narrowed segment so more blood can flow through.

A metal mesh called a stent may be used to keep the artery open if the balloon inflation is not enough.

Who is a renal angioplasty for?

A renal angioplasty may be recommended if doctors think that one or both renal arteries has narrowed due to a build-up of fatty deposits. This is known as renovascular disease (RVD).

Because it lowers the kidneys’ supply of oxygen-rich blood, RVD can lead to reduced kidney function, along with high blood pressure.

Is renal angioplasty safe? Are there any alternatives?

Renal angioplasty is usually very safe and may prevent the need for surgery. But, like all procedures, there are some risks. It’s common to have short-term bruising where the needle was inserted into the artery. Occasionally, if the bruise becomes very large, a small procedure may be needed to treat it.

Other potential risks can include:

• damage to the renal artery from the catheter or balloon. This happens in fewer than 1 in 100 cases and can usually be repaired with a stent
• infection at the injection site, which can be treated with antibiotics
• reactions to the contrast dye. There is a small chance that the injected X-ray dye can affect the kidney function. Serious reactions are very rare
• failure to open up the narrowed area. Your doctor will discuss other approaches
• some bits of fatty material or a blood clot can move during the procedure and travel further along the bloodstream. This is called an embolism. If it lodges in a small kidney blood vessel, it can reduce blood flow to a small area of the kidney.

Where will the renal angioplasty take place?

In the hospital’s X-ray or radiology department.

It will be performed by an interventional radiologist, a healthcare professional who specialises in using catheters and imaging equipment.

What happens before the procedure? How do I prepare?

• Tell the team about any allergies you have and give them a list of your medications. They’ll tell you if you need to stop any for a day or two. Otherwise, take your medicines as usual.
• Follow your hospital’s guidance on eating and drinking beforehand. You might be asked to drink more before the procedure. If you have severe kidney problems, you may need extra fluids through an intravenous (IV) drip before or after the procedure.
• When you arrive at the hospital, you’ll have some basic health checks. The interventional radiologist will explain what’s going to happen and will ask you to sign a form consenting to the procedure.

What happens during the renal angioplasty?

• You’ll be asked to change into a hospital gown and lie on your back on the X-ray table, where you’ll be attached to a monitor that checks your oxygen levels and blood pressure.
• After cleaning and numbing the area with local anaesthetic, the radiologist will make a small cut. They will insert a needle through it into the artery and use X-ray to guide the catheter into place.
• After injecting dye through the catheter, the radiologist will use X-ray to confirm the narrowing (this part of the procedure is an angiogram).
• They will then insert a different catheter into the narrowed segment and briefly inflate the balloon to open the artery. If the artery doesn’t open enough, they may insert a new catheter with a stent on it.
• At the end of the procedure, the radiologist will remove the catheter and press firmly on the site to prevent bleeding from the artery.
• The procedure isn’t usually painful, but you may feel some pressure in your groin, and balloon inflation may feel uncomfortable in your back. The team can give you pain relief medicine if needed. When the contrast dye is given, you may feel a brief warm flush or the feeling that you have passed urine. You may also have a metallic taste in your mouth.

The procedure time can vary but you should allow around one and a half hours in the X-ray department.

What happens immediately after the procedure?

• The nurses will monitor you on the ward for a few hours after the procedure, making sure you drink lots of fluids. They may also check your pulse and blood pressure to make sure there are no problems and check the entry point at the skin to make sure there is no bleeding from it.
• You’ll need to lie flat to help prevent bleeding. You’ll be told when you can sit up and move around.
• If you need IV fluids, you may be kept on them for up to six hours.
• After a kidney function test, you’ll be discharged home. This may be on the same day, depending on the time you have the procedure.

What should I expect when I get home?

Your hospital will give you guidance on activity and may suggest avoiding strenuous activity while the puncture site heals.

Make sure you know how to get in touch with your healthcare team in case of any problems. Contact your team if you develop any pain, a rapidly enlarging bruise, bleeding that doesn’t stop, a fever or have concerns about the amount of urine you’re passing.

How will I get the results?

The radiologist will keep notes about the procedure, and will inform your kidney doctor, who will plan follow-up and ongoing treatment with you.

Is there anything else I need to know?

Keep any follow-up appointments so your team can review blood pressure, kidney function and next steps.

Publication date: 01/2026

Review date: 01/2029

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