In bilateral (both-sided) and unilateral (one-sided) renal artery stenosis associated with high blood pressure, controlling the blood pressure with usual blood pressure medications is the first and the safest treatment. ACE inhibitors or ARB medications with or without a diuretic (water pill) may be tried first. This approach may be associated in some patients with worsening of their kidney function. Therefore, kidney function needs to be followed closely and if worsening of kidney function is evident, these medications may need to be stopped.
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