Renal Artery Stenosis: Sensitivity and Specificity

Introduction: i.e. renovascular hypertension - systemic hypertension caused by stenosis of the renal artery (leading to renal hypotension and thus increased renin secretion)

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The sensitivity and specificity of findings for Renal Artery Stenosis are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive and Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Magnetic Resonance Angiography	+ 0 -	100%	98%
sensitivity much lower for FMD (which affects more distal portion of the artery). In another study, sens / spec was only 62% / 84% Study: AJR Am J Roentgenol. 1999;173(5):1279. PMID 10541105 Kidney Int. 1995;48(4):1332. PMID 8569096
[ + ] CT angiography	+ 0 -	98%	94%
sensitivity lower in another series with many FMD patients (see comments in MRA finding) - only 28% in patients with FMD Study: Radiology. 1995;196(3):667. PMID 7644627 Ann Intern Med. 2004;141(9):674. PMID 15520423
[ + ] Doppler Ultrasound	+ 0 -	85%	92%
by peak systolic velocity > 180 cm/s (the most accurate US parameter) Study: AJR Am J Roentgenol. 2007;188(3):798 PMID 17312071

Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Systolic and Diastolic Abdominal Bruit	+ 0 -	39%	99%
Study: Ann Intern Med. 1979 Oct;91(4):617-22. PMID: 484965
[ + ] Epigastric or Flank Bruit	+ 0 -	63%	90%
Study: Lancet. 1966 Jul 16;2(7455):117-21. PMID: 4161375 cited in The Rational Clinical Examination