This study demonstrates a high false-positive rate (94%) when the PSV is in the mid-main renal artery. We suspect this pattern is due to the tortuous mid-main renal artery causing falsely elevated velocities that meet criteria for RAS. Fibromuscular dysplasia may also produce the same pattern and should be distinguished from vessel tortuosity. If the false-positive rate of Doppler ultrasound can be decreased, fewer patients will be subjected to an unnecessary follow-up study and possibly invasive procedures.

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