Magnetic resonance angiography and Doppler scanning for detecting atherosclerotic renal artery stenosis.
BACKGROUND
Atherosclerotic renal artery stenosis (ARAS) is a progressive but potentially reversible chronic kidney disease. Although the high sensitivity and specificity of renal Doppler scanning (RDS) for ARAS has been reported in western countries, ARAS has not been detected by RDS. This study used magnetic resonance angiography (MRA) to evaluate the sensitivity and specificity of RDS for detecting ARAS among outpatients at a nephrology clinic, and to calculate the degree of underestimation of ARAS by RDS.


METHODS
A total of 257 outpatients, aged > 50 years were examined for ARAS by RDS and MRA.


RESULTS
Thirty-seven (14.4%) and 139 (54.1%) of 257 patients had stenosis detected by RDS and MRA, respectively. Among the 220 patients whose RDS results were negative, MRA detected stenosis in 111 (50.45%). Multivariate logistic regression analysis showed that age > 65 years, duration of smoking, coronary artery disease, and serum creatinine levels > 354 mmol/L (4 mg/dL) were significant and independent factors that influenced ARAS in patients with negative results by RDS.


CONCLUSIONS
RDS might still be the diagnostic procedure of choice for screening outpatients for ARAS because it is inexpensive, convenient, able to detect severity, and avoids the use of contrast media. When RDS is negative in aged people who have smoked longer than 20 years, with coronary artery disease or serum creatinine > 4 mg/dL, MRA is recommended for further evaluation of ARAS.
Ng
Yee-Yung
YY
Division of Nephrology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. yyng@vghtpe.gov.tw
Shen
Shu-Huei
SH
Wang
Hsin-Kai
HK
Tseng
Hsiuo-Shan
HS
Lee
Rheun-Chuan
RC
Wu
Shiao-Chi
SC
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D012078:Renal Artery Obstruction / Q000175:diagnosis* / Q000628:therapy; D018608:Ultrasonography, Doppler / Q000379:methods*