Document Detail


Role of captopril renography in the diagnosis of renovascular hypertension.
MedLine Citation:
PMID:  8768915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Eighty-six hypertensive patients with clinical suspicion of renovascular hypertension (RVH) were evaluated by captopril renal scintigraphy (CRS) and intra-arterial digital subtraction angiography (IADSA) to determine the usefulness of CRS in the diagnosis of RVH and to predict the outcome of revascularization procedures. Technetium 99m-diethlenetriaminepentaacetic acid (DTPA) renal scintigraphy was performed on 2 consecutive days before and after captopril administration. Captopril renal scintigraphy was considered positive if there were changes in the time activity curve according to the criteria specified by the American Society of Hypertension working group. Captopril renal scintigraphy data were compared with presence or absence of anatomic renal artery stenosis (RAS). Of 86 hypertensive patients investigated, 45 had RAS. Aortoarteritis was the cause of RAS in 40 (89%) patients. Revascularization was done in 25 patients, and response to revascularization was compared with that of captopril renography. Compared with IADSA, CRS showed a sensitivity of 82.8% and a specificity of 98.2%. Fourteen patients had bilateral RAS on IADSA. In these patients, CRS was suggestive of bilateral disease in seven patients, unilateral in four, and negative in three. Comparison of CRS with the results of revascularization showed a sensitivity and specificity in detecting curable RAS (RVH) of 95% and 100%, respectively (positive predictive value, 100%; negative predictive value, 85%). In conclusion, we found CRS to be useful in the diagnosis of RVH due to aortoarteritis.
Authors:
B R Mittal; P Kumar; P Arora; V Kher; M K Singhal; A Maini; B K Das
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  28     ISSN:  0272-6386     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-09-17     Completed Date:  1996-09-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  209-13     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Angiography, Digital Subtraction / methods
Angiotensin-Converting Enzyme Inhibitors / diagnostic use*
Antihypertensive Agents / diagnostic use*
Captopril / diagnostic use*
Child
Female
Humans
Hypertension, Renovascular / etiology,  radiography,  radionuclide imaging*
Kidney / radiography,  radionuclide imaging
Male
Middle Aged
Radioisotope Renography / methods*
Renal Artery Obstruction / complications,  radiography,  radionuclide imaging
Sensitivity and Specificity
Technetium Tc 99m Pentetate / diagnostic use
Time Factors
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 62571-86-2/Captopril; 65454-61-7/Technetium Tc 99m Pentetate

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


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