Table 3.1.

Evaluation for Renal Artery Stenosis—Potential Signs and/or Symptoms

Indication		Appropriate Use Score (1–9)
Creatinine Elevation and/or Hypertension
34.	• Malignant hypertension (see Assumptions)	A (8)
35.	• Resistant hypertension (see Assumptions)	A (8)
36.	• Worsening blood pressure control in long-standing hypertensive patient	A (8)
37.	• Hypertension in young person (age <35 years)	A (8)
38.	• Unexplained size discrepancy between kidneys (>1.5 cm; in longest dimension)	A (7)
39.	• Unknown cause of azotemia (eg, unexplained increase in creatinine)	A (7)
40.	• Increased creatinine (>50% baseline or above normal levels) after the administration of ACE/ARBs	A (8)
41.	• Acute renal failure with aortic dissection	A (8)
42.	• Epigastric bruit	A (7)
Heart Failure of Unknown Origin
43.	• Refractory CHF	A (7)
44.	• “Flash” pulmonary edema	A (8)

ACE = angiotensin-converting enzyme inhibitor; ARB = angiotensin II receptor blocker; CHF = congestive heart failure.