As mentioned before, there are some forms of blood pressure or conditions that can damage the kidney that can damage themselves. In the setting of a renal vascular hypertension, or a renal artery stenosis. This is a condition that can occur because of several different causes. The most common causes are renal vascular hypertension is what is called as atherosclerotic disease this is the kind of disease where you have cholesterol plaques that build up in the main arteries that feed the kidney and there is cholesterol plaques building up in those vessels and the arteries become narrowed and the force or the pressure within the kidney increases. The blood flow and the pressure within the kidney increases. This can actually cause kidney damage down the line and this is the cause of hypertension itself. Physician happens on one side with one artery feeding the kidney on both sides with both kidneys. The way that it is typically managed, is usually upfront with medications, majority of the cases it is managed with medications and in a few cases it and be managed procedurally by an interventional radiologist or a vascular doctor where they have to open up the blockages within these arteries and occasionally put in stents to keep those blockages from reaccumulating. On occasion it is done in conjunction with medications, otherwise in majority of cases, these kind of issues are dealt medically with medication.