Causes of reduced renal blood flow include Obstructive renal artery disease (eg, atheroma, stenosis) Renal vasoconstriction (as occurs in accelerated hypertension) Edematous disorders (eg, heart failure, cirrhosis with ascites, nephrotic syndrome) Secretion may be normal in heart failure, but hepatic blood flow and aldosterone metabolism are reduced, so circulating levels of the hormone are high.