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The most common cause of renal artery stenosis is a buildup of fatty deposits called plaque. It can happen in either or both renal arteries. This is often called "hardening of the arteries," or atherosclerosis. The buildup can narrow the artery and reduce blood flow to the kidneys.
Renal artery stenosis can also be caused by fibromuscular dysplasia. This is a condition in which some of the cells that line the renal arteries grow or don't develop the right way. This growth can cause the arteries to narrow.