Are demographic caracteristics of hypertensive patients different with renal artery stenosis?

Atheromatous renal disease is more and more involved in end stage renal fai lure in polyatheromatous patients. The goal of this work was to study the demographic differences between hype rtensive patients with renal artery stenosis (PAS) or without PAS. Method: Between November 1995 and July 1997, 49 hypertensive patients were included consecutively for a suspicion of RAS. Age, sex, hypertension histo ry, tabagism, cardiovascular heredity, body mass index, diabetes history, h ypercholesterolemia, kaliemia, serum creatinine. creatinine clearance, syst olic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressur e (PP) were studied. A renal echo-doppler and a renal TDM were performed in all patients. A renal arteriography was performed in 23 patients with a RA S suspicion after the two morphologic exams. The demographic characteristic s of both clinical groups control (group 1) and patients with unilateral RA S (group 2), were compared. Statistics: Descriptive analysis, Wilcoxon test, Khi 2 test, spearman corre lation (P<0.05). Results: Group 2 patients were significantly older than group 1 patients (p =0.008) with a mean age difference of 8 years. Creatinine clearance was low er in patients suffering from RAS with a mean difference of 23 mL/min betwe en groups 1 and 2 (p=0.0007) but we also had to take into account the negat ive correlation existing between creatinine clearance and age (r=0.63; p=0. 0001) when interpreting these results. The DBP was lower (p=0.03) and the P P higher (p=0.01) in group 2. The SBP was higher in group 2 but this result was not significant. Mean differences in SBP and PP between group 1 and gr oup 2 were 6 mmHg and 15 mm Hg respectively. Smoking was more common in gro up 2 (p=0.04). The history of hypertension, cardiovascular heredity, sex ra tio (MIF), body mass index and prevalence of diabete were comparable betwee n the two clinical groups. Conclusion: Although there were demographic differences between the two cli nical groups, no clinical or biological variable could be used alone to ide ntify which patients suffered from renal stenosis, because the distribution of these variables did not differ significantly between the two groups and the effective was small. Then, we thought that Krijnen's predictive rule i s interesting in the screening of hypertensive patients with RAS suspicion.