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Renal vascular pathologies are important causes of the chronic renal failure progression. This work aims to define retrospectively a score based on simple clinical and paraclinical helping to select atheromatous renal stenosis affected patients; 67 patients more than 50 years old have been explored by arteriography because of degradation of the renal function or hypertension: 45 of them had one, or many, significant stenosis of the renal arteries. Were analyzed: clinical data: age, weight, sex, blood pressure, previous ateromatous lesions (cardiac, peripheral, aortic), smoking, associated diabetes; biological data: serum cholesterol and creatinine, creatinine variation under angiotensin-coverting enzyme inhibitor or sodium depletion, kaliemia; radiologic data: kidney size through scanning, renal arterial and aortic calcifications on abdominal plain films and profile. The group with and without stenosis differed considerably for age (68.9 vs 64 years old, p0.05), smoking (26.3 vs 11.5 packet-year, p0.001), variation of creatinine after sensibilisation (140 mumol/l vs 17 mumol/l, p0.001), presence of arterial calcification (p0.001). A score taking in to account these four criteria was established with performances in terms of specificity and sensibility amounted to 83%.The reliable aspect of this score enabling to define a group seriously risking a renal stenosis must be checked through a prospective study. |
