18. Prognostic value of Captopril renal scintigraphy (CRS). Follow-up of revascularized hypertensive patients

Dondi, Maurizio; Fanti, Stefano; Mirelli, Michele; Zuccalà, A

doi:10.1097/00006231-199205000-00028

Cited by 7 publications

(12 citation statements)

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“…Most investigators have used oral captopril in doses of 25 mg [20, 44, 47-52, 54, 55] or 50 mg [49,51,[56][57][58]60] with equivalent accuracy and safety. Because of the great variability of captopril absorption, reducing from 50 to 25 mg or even smaller doses may risk incomplete ACE inhibition without a concurrent increase in safety, given the remarkable absence of side-effects or toxicity of CRS.…”

Section: Which Test Conditions?mentioning

confidence: 99%

The diagnosis of renovascular hypertension: the role of captopril renal scintigraphy and related issues

Prigent

1993

Eur J Nucl Med

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This article reviews the screening and diagnostic tests used in the detection of significant renal artery stenosis and renovascular hypertension. After addressing the pathophysiological considerations necessary for correct diagnostic test interpretation, this review critically surveys the recent advances in, and the limitations of, relevant investigational procedures and in particular focuses on the efficacy and issues of angiotensin-converting enzyme inhibitor renal scintigraphy.

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Section: Which Test Conditions?mentioning

confidence: 99%

The diagnosis of renovascular hypertension: the role of captopril renal scintigraphy and related issues

Prigent

1993

Eur J Nucl Med

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“…There is a sensitivity and specificity for both unilateral and bilateral RAS of around 85 and 75% (range 42-100%), respectively, when hippuran is used as a marker [14][15][16][17], and around 85 and 90% (range 60-100%), respectively, for 99m Tc DTPA renography [5,[18][19][20][21]. The preliminary results for MAG3 fall in the same range [1,22,23]. However, the optimal diagnostic criteria of an abnormal MAG3 study still needs to be determined [24].…”

Section: Discussionmentioning

confidence: 90%

“…Sensitivity and specificity for each parameter were found to be 65-89 and 85-94%, respectively [22].…”

Section: Discussionmentioning

confidence: 95%

Quantitative Residual Cortical Activity Measurement: Appropriate Test for Diagnosis of Renal Artery Stenosis?

Gezici

Ersay²,

Antevska³

et al. 1999

Urol Int

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Objectives: To evaluate the diagnostic validity of quantitative measurement of residual cortical activity (RCA) in renal artery stenosis (RAS). Methods: In 45 patients with a high clinical likelihood of renovascular hypertension (RVH) and unimpaired renal function, dynamic imaging was performed after an intravenous bolus injection of 148 MBq ^99mTc MAG3 for both baseline renoscintigraphy and captopril renography following oral application of 50 mg captopril. RCA was measured according to the Sfakianakis method: RCA = cortical counts at 20 min/counts at peak ×100%. An increase in RCA of ≥5% from baseline was considered indicative of RAS. After renography, all patients underwent selective transfemoral angiography with the digital subtraction technique. A luminal reduction of ≥50% was considered as proof of RAS. Results: The number of kidneys that had a change of ≥5% in RCA values was 12 (27.2%) in normal kidneys, 7 (58.3%) in the patients with bilateral RAS, 14 (82.3%) in the patients with unilateral RAS, and 21 (72.4%) in overall kidneys with RAS. The positive test ratio in pathologic groups was significantly higher than normal (p < 0.05). The sensitivity and specificity of the RCA test were 72.4 and 72.7%, respectively; the positive and negative predictive values were 63.6 and 80%, respectively. Conclusion: Quantitative measurements of RCA can be used as a diagnostic parameter of renal artery stenosis and may contribute of the diagnostic accuracy of visual interpretation and other renographic diagnostic criteria.

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“…26 captopril renal scintigraphy in RVH and showed that positive preoperative renal scintigraphy in strong predictor of hypertension curability of revascularization. 27 As far as ACE inhibitor scintigraphy is concerned there are many studies available which are shown in Table 1, but yet there is no consensus on scintigraphy protocol including radiopharmaceutical, sequence of studies, ACE inhibitors, their dose and specific criteria. [8][9][10][11][12][13][14][15][16][17][18][19][20] Nally JV et al achieved the sensitivity and specificity of 100% and their criteria for positive test were decrease in maximum activity, delayed uptake, widening of peak activity and slowing the excretory phase.…”

Section: Discussionmentioning

confidence: 99%

Captopril Renal Scintigraphy in Screening and Diagnosis of Renal Artery Stenosis - A Prospective Study

et al. 2013

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The present study was carried out to assess the role of Tc99m-DTPA captopril renal scintigraphy in screening and diagnosing of patients with renal artery stenosis. Materials and Methods: A total of 26 hypertensive patients with a clinical suspicion of RAS underwent baseline and captopril scintigraphy using 259-370 MBq (7-10mCi) of Tc99m-DTPA. The captopril scintigraphy was done after oral dose of 50mg of captopril with in three baseline study. DSA was done in all patients irrespective of scintigraphy results due to high clinical suspicion of RAS. Results: Of 26 patients, 18 had renal artery stenosis (10 unilateral, 8 bilateral), making a total of 26 involved RA on DSA. Of these 26 involved RA, 16 were stenosis> 60%, 2 were stenosed< 60% while 8 were completely occluded. Of the sixteen RA with stenosis > 60%, only 12 were detected by captopril scintigraphy (Sensitivity-75%). Eight kidneys with complete occlusion, 6 were non-functioning and 2 were poorly functioning (<20%) on scintigraphy. Among 27 normal RA, (25 normal and two <60% stenosis) only 19 were negative on scintigraphy (specificity-70%). Two kidneys with less than 60% stenosis were positive on scintigraphy. The overall accuracy of captopril DTPA scintiography was found to be 72.1% with PPV and NVP of 66.7% and 82.6% respectively. Two patients with accessory RA were not picked up on captopril scintigraphy. Conclusion: Tc99m-DTPA captopril scintigraphy has average sensitivity and specificity. The effectiveness of captopril scintigraphy in diagnosis of completely occuluded RA, accessory RAS and RAS in poorly functioning kidney is poor, therefore this test can not be considered as screening test for RVH.

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18. Prognostic value of Captopril renal scintigraphy (CRS). Follow-up of revascularized hypertensive patients

Cited by 7 publications

References 0 publications

The diagnosis of renovascular hypertension: the role of captopril renal scintigraphy and related issues

The diagnosis of renovascular hypertension: the role of captopril renal scintigraphy and related issues

Quantitative Residual Cortical Activity Measurement: Appropriate Test for Diagnosis of Renal Artery Stenosis?

Captopril Renal Scintigraphy in Screening and Diagnosis of Renal Artery Stenosis - A Prospective Study

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