Screening for Renal Artery Stenosis: Are Scans More Accurate Than Clinical Criteria?
Authors: Christopher S. Wilcox
Journal: Annals of Internal Medicine (1998)

Editorials1 November 1998Screening for Renal Artery Stenosis: Are Scans More Accurate Than Clinical Criteria?Christopher S. Wilcox, MD, PhDChristopher S. Wilcox, MD, PhDGeorgetown University Medical Center; Washington, DC 20007Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-9-199811010-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Deciding which patients with hypertension to investigate for renal artery stenosis remains one of the most perplexing and controversial decisions facing the internist. No screening test has been sufficiently accurate, inexpensive, noninvasive, reproducible, and adequately validated in practice settings to be accepted universally as a screening procedure. Ideally, the first step in diagnosis is to identify a group of patients with a prevalence of renal artery stenosis that is high enough to justify screening, the second step is to select a test with a high sensitivity, and the third step is to perform arteriography in patients who have positive test ...References1. Wilcox CS. Use of angiotensin-converting-enzyme inhibitors for diagnosing renovascular hypertension. Kidney Int. 1993; 44:1379-90. Google Scholar2. Rossi GP, Pavan E, Chiesura-Corona M, Bader M, Paganini G, Cesari M, et al. Renovascular hypertension with low-to-normal plasma renin: clinical and angiographic features. Clin Sci (Colch). 1997; 93:435-43. Google Scholar3. Blaufox MD, Fine EJ, Heller S, Hurley J, Jagust M, Li Y, et al. Prospective study of simultaneous orthoiodohippurate and diethylenetriaminepenta-acetic acid captopril renography. J Nucl Med. 1998; 39:522-8. Google Scholar4. van Jaarsveld BC, Krijnen P, Derkx FH, Oei HY, Postma CT, Schalekamp MA. The place of renal scintigraphy in the diagnosis of renal artery stenosis. Fifteen years of clinical experience. Arch Intern Med. 1997; 157:1226-34. Google Scholar5. Krijnen P, van Jaarsveld BC, Steyerberg EW, Man in 't Veld AJ, Schalekamp MA, Habbema JD. A clinical prediction rule for renal artery stenosis. Ann Intern Med. 1998; 129:705-11. Google Scholar6. Davidson RA, Barri Y, Wilcox CS. Predictors of cure of hypertension in fibromuscular renovascular disease. Am J Kidney Dis. 1996; 28:334-8. Google Scholar7. Barri YM, Davidson RA, Senler S, Flynn TC, Seger JM, Harward TR, et al. Prediction of cure of hypertension in atherosclerotic renal artery stenosis. South Med J. 1996; 89:679-83. Google Scholar Author, Article, and Disclosure InformationAffiliations: Georgetown University Medical Center; Washington, DC 20007Corresponding Author: Christopher S. Wilcox, MD, PhD, Georgetown University Medical Center, Division of Nephrology and Hypertension, 3800 Reservoir Road, NW, PHC F6003, Washington, DC 20007. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Clinical Prediction Rule for Renal Artery Stenosis Pieta Krijnen , Brigit C. van Jaarsveld , Ewout W. Steyerberg , Arie J. Man in 't Veld , Maarten A.D.H. Schalekamp , and J. Dik F. Habbema Metrics Cited byClinical Problems in Renovascular Disease and the Role of Nuclear MedicinePrevalence of renal artery stenosis in patients undergoing cardiac catheterizationTechniques in Interventional Radiology: Renal CT AngiographyRenovascular Hypertension: Diagnosis and TreatmentManipulation of the Renin Angiotensin System in Peripheral Arterial DiseaseReferencesUtilidad de la clínica y el laboratorio en el diagnóstico de la estenosis de arteria renal en pacientes hipertensos con arteriosclerosis concomitantePrediction Rule for Renal Artery StenosisEugene J. Fine, MD and M. Donald Blaufox, MDOptimizing the benefits of renal artery stentingNoninvasive evaluation of renovascular disease 1 November 1998Volume 129, Issue 9Page: 738-740KeywordsACE inhibitorsAngiographyBlood pressureDysplasiaHypertensionPlasma renin activityRadionuclide imagingRenal arteriesSpecificityStenosis Issue Published: 1 November 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...