PP.39.07

Abstract

Objective: Renal artery stenosis (RAS) is associated with lesions in other vascular territories and the identification of RAS may include clinical markers/laboratory atherosclerosis coexisting with the investigation of peripheral arterial disease (PAD). We hypothesized that markers of the presence of PAD could be a useful to identify severe RAS (greater than or equal to 70%) in hypertensive patients referred for renal angiography. Design and method: Eight-two hypertensive patients were included in clinical suspicion of renovascular hypertension, whose further investigation (Doppler, angiography and / or renal scintigraphy) indicated possibility of RAS. All patients underwent renal arteriography and significant stenosis significant was defined as an obstruction greater than or equal to 70%. Clinical variables and complementary examination were considered in the univariate analysis for associated with presence of severe RAS. All patients were examined for presence of PAD based on presence of intermittent claudication (IC) and ankle-brachial index (ABI). Results: Severe RAS was present in 32/82 (39%). Patients with severe RAS were older (63 ± 12 vs. 56 ± 12 years; p = 0.006), had more intermittent claudication (55 vs. 45%; p = 0.027) and more prevalence of ABI < 0.9 (44% vs. 20%, p = 0.021) compared to patients without severe RAS. Binary logistic regression analysis showed that IC was independently associated with severe RAS (OR: 3.33; 95% CI 1.03–10.82; p = 0.04). Conclusions: We concluded that the presence of intermittent claudication is a clinical predictor of severe RAS in patients under clinical suspicion of renovascular hypertension.