What question did this study set out to answer?

To evaluate the prognostic accuracy of renal vein and peripheral renin determinations in predicting clinical benefit following corrective surgery for unilateral renal artery stenosis.

December 12, 1977JAMA

Predictive Value of Renin Determinations in Renal Artery Stenosis

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Why the study?

Do renal vein and peripheral renin levels predict operative benefit in patients with unilateral renal artery stenosis?

Population

66 patients with unilateral renal artery stenosis who underwent corrective surgery, and a control group of…

Comparison

Renal vein and peripheral renin level… vs Nonlateralizing renin data

Design

Cohort

Authors

MMMorton H. MaxwellCedars-Sinai Medical Center

Discussion

Member takes

Implication

Nonlateralizing renin data were associated with operative benefit in unilateral renal artery stenosis; challenges predictive schemes and leaves open optimal selection criteria.

Key Points

To evaluate the prognostic accuracy of renal vein and peripheral renin determinations in predicting clinical benefit following corrective surgery for unilateral renal artery stenosis.
Analyzed renal vein and peripheral renin levels in 66 patients with unilateral renal artery stenosis who underwent surgical revascularization, with operative selection conducted independently of renin measurements.
Compared renin levels against a control cohort of 82 patients with essential hypertension to establish baseline lateralization cutoffs (ipsilateral:contralateral ratio ≥ 1.5 and contralateral:peripheral ratio ≤ 1.3).
Fifty-three percent of patients with confirmed renovascular hypertension exhibited renal vein renin ratios below 2.0, remaining within the 95% confidence limit established for the control group.
All 34 patients presenting with lateralizing renin data achieved operative benefit, but 23 patients with nonlateralizing renin ratios also benefited from surgery.
No proposed diagnostic schema for analyzing renin levels achieved a sensitivity greater than 75% for detecting renovascular hypertension.

Structured PICO

Do renal vein and peripheral renin levels predict operative benefit in patients with unilateral renal artery stenosis?

Population

66 patients with unilateral renal artery stenosis who underwent corrective surgery, and a control group of 82 patients with essential hypertension.

Intervention

Renal vein and peripheral renin level determinations (lateralizing renin data)

Comparator

Nonlateralizing renin data

Outcome

Operative benefitsurrogate

Nonlateralizing renin data do not necessarily herald operative failure in patients with unilateral renal artery stenosis and should not be used to exclude surgical intervention.

Cite This Study

Morton H. Maxwell (1977) studied this question.

synapsesocial.com/papers/6a70e3d8f44fa9f079dea159 https://doi.org/10.1001/jama.1977.03280250043020

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Implication

Nonlateralizing renin data were associated with operative benefit in unilateral renal artery stenosis; challenges predictive schemes and leaves open optimal selection criteria.

Predictive Value of Renin Determinations in Renal Artery Stenosis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Predictive Value of Renin Determinations in Renal Artery Stenosis

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Also Consider