Reliability of intrarenal Doppler sonographic parameters of renal artery stenosis

The goal of this study was to retrospectively evaluate false-negative results of Doppler sonography in the diagnosis of renal artery stenosis (RAS) using intrarenal criteria.

We reviewed the clinical data and Doppler sonographic data for all patients in whom a diagnosis of RAS had been confirmed angiographically between November 1992 and January 2001. Mean intrarenal acceleration and acceleration time values-data obtained directly from color Doppler sonography-and findings of angiographic examination of the kidneys and stenotic renal arteries were evaluated.

During the study period, 55 cases of RAS had been angiographically confirmed in 46 patients (25 male and 21 female; mean age, 50 +/- 19 years [+/- standard deviation]). Intrarenal arterial acceleration, acceleration time values, or both were abnormal in 42 kidneys (76%) (group A) and normal in 13 kidneys (24%) (group B). The mean age +/- standard deviation was significantly higher for patients in group B (60 +/- 12 years) than for those in group A (47 +/- 20 years) (p > 0.05). In group B, most of the stenotic lesions were atherosclerotic, and in all kidneys but 1, the lesions were located at the renal ostium or the proximal half of the artery.

Isolated use of intrarenal Doppler sonographic criteria for RAS may lead to an unacceptably high incidence of false-negative results in the diagnosis of this condition, especially in elderly patients.