Prevalence and predictors of renal artery stenosis in hypertensive patients undergoing elective coronary procedures.

This study explored the prevalence and predictors of renal artery stenosis in a cohort of 525 hypertensive patients referred for elective coronary procedures. Patients underwent coronary and renal arteriography. The study defined renal artery stenosis as > or =60% luminal obstruction (physiologic or hemodynamic significance was not tested). Patients were classified into groups of those with normal renal arteries, those with insignificant renal artery stenosis, and individuals with significant renal artery stenosis. The mean age was 52.6+/-8.5 years, and 403 (76.8%) were males. Significant renal artery stenosis was found in 3.6%. It correlated significantly with hypertension duration (P=.005), history of cerebrovascular stroke (P=.01), history of angioplasty to >1 coronary vessel (P=.003), and 3-vessel coronary disease (P=.0003). Multivariate regression analysis identified 2-vessel and 3-vessel coronary artery disease as independent predictors of renal artery stenosis, with odds ratios of 4.9 and 12.1, respectively. It was concluded that invasive screening for renal artery stenosis was probably warranted only in hypertensive patients with multivessel coronary disease referred for elective coronary procedures.