Doppler ultrasound scanning in the detection of renal artery stenosis in hypertensive patients

Abstract

The diagnostic accuracy of Doppler ultrasound in the detection of renal arterial disease has been assessed in a prospective study of 61 hypertensive patients. The findings of Doppler ultrasound were compared with the results of renal angiography. In 15 patients (24.5%) no accurate Doppler signs could be obtained and the Doppler ultrasound examination was considered a technical failure. Of the remaining 46 patients, 24 had renal artery stenosis. Nine of the stenoses were not detected by Doppler ultrasound and in three patients a false positive diagnosis of renal artery stenosis was made. The sensitivity of Doppler ultrasound was 62.5%, the specificity 86.4% and the overall diagnostic accuracy was 73.9%. By comparing the 15 patients in whom Doppler ultrasound failed with the 46 in whom it was successful, age appeared to be higher and creatinine clearance lower in the failure group. By comparing the 34 patients with true positive and true negative results with the 12 patients with false results, no significant differences were found. In a multivariate analysis, higher age showed a significant relation to failure of Doppler ultrasound. Doppler ultrasound has limited value in the screening of hypertensive patients for renal artery stenosis.

Renovascular disease in patients with hypertension: detection with duplex ultrasound

“…However, the intrarenal parameters are probably influenced by several, complex factors (ie, pulse, diastolic blood pressure) which may also account for the differences in the tabulated results. 32,33 Direct visualisation of the main renal arteries with duplex ultrasound combined with Doppler spectral waveform analysis in the main and segmental renal arteries 31,[33][34][35][36][37][38][39] does not seem to result in significantly better results with sensitivities ranging from 47-89% and specificities from 76-98% (Table 4c).…”

Dendritic cells tolerized with adenosine A2AR agonist attenuate acute kidney injury

“…In recent years, an AKI model was established that more closely mimics human renal artery hypoperfusion during cardiac surgery (35)(36)(37)(38). To demonstrate that our results can be recapitulated in the artery occlusion model, we successfully established a mouse renal artery IRI model.…”

Clinical and biochemical criteria in the detection of renal artery stenosis

“…In this respect non-invasive imaging techniques are an option. Doppler ultrasonography performed in the entire group would be costly at the gain of discovering R A S in at most 60% of the patients with proved RA S [5,21,22]; in this study, in only 62 of 104 patients. Magnetic resonance angiography of the renal arteries shows R A S and with application of the latest developments in the technique gives very reliable results, but to use it as a screening procedure would be very costly [6,23].…”

“…have not yet provided a replacement for angiography [4][5][6]. Most of the screening methods investigated proved not to be sufficiently reliable because of their relatively low sensitivities [3].…”