Key result
Renal artery Doppler yields only 48% diagnostic accuracy for detecting stenosis versus angiography.
Why the study?
The efficiency of renal artery Doppler in diagnosing secondary hypertension among cardiac patients was uncertain.
Does renal artery Doppler improve the diagnosis of secondary hypertension in cardiac patients?
Cross-Sectional (n=50)
No
Does renal artery Doppler improve the diagnosis of secondary hypertension in cardiac patients?
Renal artery Doppler has low sensitivity and diagnostic accuracy (48%) for evaluating secondary hypertension in cardiac patients, suggesting its routine use should be restricted to minimize costs and time.
Renal artery Doppler's low sensitivity cautions against routine use for stenosis detection; leaves open need for better noninvasive alternatives in hypertensive cardiac patients.
Objective: To evaluate the efficiency of renal artery Doppler in diagnosis of secondary hypertension among cardiac patients. Study Design: Analytical Cross-sectional study. Place and Duration of Study: The present study was performed at Tertiary Care Center, Rawalpindi from Jan 2019 to July 2019. Methodology: The study comprised of 50 patients with age range of 12-75 years with 90% confidence interval and 10% margin of error with prevalence of hypertension in Pakistan as 26.34%12. The study population included hypertensive patients referred for Doppler assessment of renal artery stenosis (RAS), in order to assess secondary cause of hypertension. The patients underwent angiography of kidneys within 14 days following Doppler assessment of RAS. The positive and negative outcome was presented as frequencies and percentages. The mean age was depicted as means ± standard deviation. The diagnostic features of specificity, sensitivity, negative predictive value and positive predictive values were calculated through a 2x2 table with angiographic findings considered as gold standard. Results: In only 4(8%) patients bilaterally raised resistive index (RI) were evident. The diagnostic attributes of Doppler showed sensitivity of 48%, positive predictive value of 100% and diagnostic accuracy of 48%. Conclusion: The role of renal artery Doppler in evaluating secondary hypertension has been over estimated. Thus, its application needs to be restricted for elderly patients to minimize time and cost expenses.
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Israr et al. (2022) conducted a cross-sectional in Hypertension (n=50). Renal artery Doppler vs. Angiography was evaluated on Diagnostic accuracy for renal artery stenosis. Renal artery Doppler demonstrated a sensitivity of 48% and diagnostic accuracy of 48% for detecting renal artery stenosis compared to angiography in hypertensive cardiac patients.
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