Prevalence of renal artery stenosis in patients undergoing cardiac catheterization: when should abdominal aortography be performed? - Results in 467 patients

Purpose. To define a subgroup of patients at increased risk of renal artery stenosis (RAS) in a population of patients undergoing cardiac catheterization. Materials and methods. A total of 467 patients (mean age of 64 years +/-11) underwent cardiac catheterization and aortography results were evaluated to detect correlations between the presence or absence of RAS and clinical and biological parameters. Results. A total of 42 (9%) patients had a renal artery stenosis. Univariate analysis defined parameters correlated with the presence of RAS: systolic blood pressure (p=0.03), pulse pressure (p=0.005), age (p<0.0001), creatinine clearance (p<0.0001), 2-vessel (p=0.028) and 3-vessel (p=0.037) coronary artery diseases. Multivariate analysis showed that the presence of RAS correlated to creatinine clearance (p=0.02) and 2-vessel coronary artery disease. A creatinine clearance between 30 and 60ml/min and multi-vessel coronary artery disease defined a subgroup at increased risk of RAS with sensitivity, specificity, positive and negative predictive values of. 47.6,90.1,32.3 and 94.6%. The prevalence of renal artery stenosis was 5.2% when both parameters were absent. Conclusion. Patients with mild renal insufficiency and multi-vessel coronary artery disease defined a subgroup of patients at increased risk of RAS (32.5%) that may benefit from abdominal aortography performed at the time of cardiac catheterization.