[Proposal of a clinical prediction score for atheromatous renal artery stenosis].
Renal vascular pathologies are important causes of the chronic renal failure progression. This work aims to define retrospectively a score based on simple clinical and paraclinical helping to select atheromatous renal stenosis affected patients; 67 patients more than 50 years old have been explored by arteriography because of degradation of the renal function or hypertension: 45 of them had one, or many, significant stenosis of the renal arteries. Were analyzed: clinical data: age, weight, sex, blood pressure, previous ateromatous lesions (cardiac, peripheral, aortic), smoking, associated diabetes; biological data: serum cholesterol and creatinine, creatinine variation under angiotensin-coverting enzyme inhibitor or sodium depletion, kaliemia; radiologic data: kidney size through scanning, renal arterial and aortic calcifications on abdominal plain films and profile. The group with and without stenosis differed considerably for age (68.9 vs 64 years old, p < 0.05), smoking (26.3 vs 11.5 packet-year, p < 0.001), variation of creatinine after sensibilisation (140 mumol/l vs 17 mumol/l, p < 0.001), presence of arterial calcification (p < 0.001). A score taking in to account these four criteria was established with performances in terms of specificity and sensibility amounted to 83%.


CONCLUSIONS
The reliable aspect of this score enabling to define a group seriously risking a renal stenosis must be checked through a prospective study.
Hadj-Abdelkader
M
M
Service de néphrologie, unité d'hémodialyse adultes, hôpital Hôtel-Dieu, CHU, bd Léon Malfreyt, 63000 Clermont-Ferrand. ahadj@chu-clermontferrand.fr
Alphonse
J C
JC
Ravel
A
A
Boyer
L
L
Deteix
P
P
D000367:Age Factors; D000368:Aged; D001161:Arteriosclerosis / Q000150:complications*; D015415:Biomarkers / Q000032:analysis; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension; D007676:Kidney Failure, Chronic / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000145:classification* / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012907:Smoking / Q000009:adverse effects
D015415:Biomarkers; D003404:Creatinine