Prediction Rule for Renal Artery Stenosis
Authors: Michael Bloch, Samuel Mann, Thomas Pickering
Journal: Annals of Internal Medicine (1999)

Letters3 August 1999Prediction Rule for Renal Artery StenosisMichael Bloch, MD, Samuel Mann, MD, and Thomas Pickering, MDMichael Bloch, MDNew York Presbyterian Hospital-Weill Medical College at Cornell University; New York, NY 10021Search for more papers by this author, Samuel Mann, MDNew York Presbyterian Hospital-Weill Medical College at Cornell University; New York, NY 10021Search for more papers by this author, and Thomas Pickering, MDNew York Presbyterian Hospital-Weill Medical College at Cornell University; New York, NY 10021Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-3-199908030-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Krijnen and colleagues (1) presented a clinical prediction rule for quantifying the probability of finding renal artery stenosis (RAS) on renal angiography. They suggest performing no further work-up in patients whose calculated score indicates a probability of RAS less than 30%. This strategy exhibited a sensitivity of 72%.We agree with the authors' emphasis on clinical criteria but have advocated a three-stage model (2) rather than a two-stage rule, in keeping with the guidelines for medical decision making recommended by Pauker and Kassirer (3).Like Krijnen and coworkers, we recommend angiography in patients with a high index of ...References1. 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. LinkGoogle Scholar2. Mann SJ, Pickering TG. Detection of renovascular hypertension. State of the art: 1992. Ann Intern Med. 1992;117:845-53. LinkGoogle Scholar3. Pauker SG, Kassirer JP. The threshold approach to clinical decision making. N Engl J Med. 1980;302:1109-17. CrossrefMedlineGoogle Scholar4. Geyskes GG, de Bruyn AJ. Captopril renography and the effect of percutaneous transluminal angioplasty on blood pressure in 94 patients with renal artery stenosis. Am J Hypertens. 1991;4:685S-9S. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Michael Bloch, MD; Samuel Mann, MD; Thomas Pickering, MDAffiliations: New York Presbyterian Hospital-Weill Medical College at Cornell University; New York, NY 10021 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 Prediction Rule for Renal Artery Stenosis Eugene J. Fine and M. Donald Blaufox Prediction Rule for Renal Artery Stenosis Vijay Rajput and Faddel Nammour Prediction Rule for Renal Artery Stenosis S.J.C.M.M. Neggers and J. van der Meulen Prediction Rule for Renal Artery Stenosis Pieta Krijnen , Ewout W. Steyerberg , and Brigit C. van Jaarsveld Metrics Cited byAthérosclérose et reins 3 August 1999Volume 131, Issue 3Page: 227KeywordsAngiographyBlood pressureDecision makingHypertensionPatient advocacyRadionuclide imagingRenal arteriesStenosis ePublished: 15 August 2000 Issue Published: 3 August 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...