Document Detail


Diagnostic usefulness of renal scanning after angiotensin converting enzyme inhibitors.
MedLine Citation:
PMID:  1889844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Radioisotopic renal scanning after angiotensin converting enzyme inhibition (ACEI) has proven to be an exciting area for research. The biologic activity of markers such as DTPA and hippuran, when combined with the physiological effects of ACEI, may provide noninvasive methods of diagnosing both renal artery stenosis and renovascular hypertension. Recent investigators have demonstrated that the sensitivities and specificities of these tests may vary widely; these differences are probably due to variations in study design, patient population, diagnostic criteria, and outcome measurements. We have reviewed these studies and discuss these possible sources of variation and their impact on the clinical usefulness of these diagnostic tests, especially in relation to the prevalence of disease in the population. Current results suggest that the post-ACEI DTPA scan is relatively accurate in the diagnosis of renal artery stenosis, with sensitivity generally greater than 90% and specificity around 95%. However, the best results in predicting the response to angioplasty or surgery in patients with renal artery stenosis have been with the use of post-ACEI hippuran in combination with furosemide (sensitivity, 96%; specificity, 95%). With confirmation of these findings and continued investigation, it is expected that accurate noninvasive tests will be available for widespread clinical use in the near future.
Authors:
R Davidson; C S Wilcox
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Publication Detail:
Type:  Editorial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Hypertension     Volume:  18     ISSN:  0194-911X     ISO Abbreviation:  Hypertension     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1991-10-11     Completed Date:  1991-10-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  299-303     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  diagnostic use*
Glomerular Filtration Rate / drug effects
Humans
Hypertension, Renovascular / diagnosis,  epidemiology
Iodohippuric Acid / diagnostic use
Kidney / drug effects,  physiopathology,  radiography*
Pentetic Acid / diagnostic use
Prevalence
Renal Artery Obstruction / diagnosis
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
D28PE14233-15/PE/BHP HRSA HHS; R01 DK 36079/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 147-58-0/Iodohippuric Acid; 67-43-6/Pentetic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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