A concise predictive nomogram for renal artery stenosis in selective patients undergoing coronary angiography

As reported scoring systems of renal artery stenosis (RAS) screening were not easily validated, we further proposed a simple method to predict or rule out RAS in selective patients undergoing coronary angiography (CAG). After preliminary inclusive criterion (severe hypertension or atherosclerosis, flash pulmonary edema, or unexplained renal dysfunction), 503 and 158 consecutive patients undergoing renal arteriography at the timing of CAG were separately enrolled between 2012 and 2015, and 2016 and 2017 as the development and validation cohort. A nomogram was derived from the multivariable logistic regression model, and its accuracy was assessed by the area under the receiver operating characteristic. Hypertension (odds ratio [OR] 17.92), estimated glomerular filtration rate ≤72.66 mL/min·1.73 m² (OR 2.75), early to late transmitral flow velocity ratio ≤1.02 (OR 2.58) and low-density lipoprotein cholesterol ≤3.17 mmol/L (OR 1.85) were identified as independent predictors for RAS. The area under the curve of the nomogram in the development and validation cohort were 0.754 (0.704, 0.804) and 0.772 (0.700, 0.844). The negative predictive value of hypertension (88.9%) was much higher than the other three predictors. The concise predictive nomogram can effectively estimate the probability of significant RAS during CAG. Along with normotensive, findings reported could easily evaluate RAS screening necessity based on clinical data.