BackgroundAging and atherosclerosis are related to renovascular hypertension in elderly
individuals. Regardless of comorbidities, renal artery stenosis is itself an
important cause of cardiovascular morbidity and mortality. ObjectiveTo define the sensitivity, specificity, positive predictive value, and negative
predictive value of noninvasive imaging tests used in the diagnosis of renal
artery stenosis. MethodsIn a group of 61 patients recruited, 122 arteries were analized, thus permitting
the definition of sensitivity, specificity, and the relative contribution of each
imaging study performed (Doppler, scintigraphy and computed tomographic
angiography in comparison to renal arteriography). ResultsThe mean age was 65.43 years (standard deviation: 8.7). Of the variables related
to the study population that were compared to arteriography, two correlated with
renal artery stenosis, renal dysfunction and triglycerides. The median glomerular
filtration rate was 52.8 mL/min/m2. Doppler showed sensitivity of
82.90%, specificity of 70%, a positive predictive value of 85% and negative
predictive value of 66.70%. For tomography, sensitivity was 66.70%, specificity
80%, positive predictive value 87.50% and negative predictive value 55.20%. With
these findings, we could identify the imaging tests that best detected stenosis.
ConclusionTomography and Doppler showed good quality and efficacy in the diagnosis of renal
artery stenosis, with Doppler having the advantage of not requiring the use of
contrast medium for the assessment of a disease that is common in diabetics and is
associated with renal dysfunction and severe left ventricular dysfunction.