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

Prigent, Alain

doi:10.1007/bf00176560

Cited by 55 publications

(18 citation statements)

References 77 publications

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“…Commenting on my review article on the diagnosis of renovascular hypertension recently published in the journal [1], Dr. Clorius et al address several points they label as "misunderstandings" concerning (1) the capabilities of, the test conditions for, and the analysis in exercise renography, and (2 a) possible pathophysiological interpretation behind an abnormal exercise renogram in hypertension. I agree completely with Dr. Clorius' statement that exercise renography fails to differentiate between incurable but improvable and therapy-unresponsive hypertension.…”

Section: Replymentioning

confidence: 99%

“…I apologize for the simple error that I did not detect when reading the proofs. Clearly, this phrase was not the result of any misunderstanding on my part, as the previous paragraph analysing the results leading to this conclusion contained the phrase "10 of 12 patients completely cured of hypertension had no exercise-induced hippuran disturbance compared with rest scintigraphy" [ 1].…”

Section: Replymentioning

confidence: 99%

“…We were sad when we read Dr. Prigent's excellent paper [1], since his review demonstrated that he had misunderstood our communications on the exercise renogram.…”

mentioning

confidence: 99%

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

Prigent

1994

Eur J Nucl Med

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Section: Replymentioning

confidence: 99%

Section: Replymentioning

confidence: 99%

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

Prigent

1994

Eur J Nucl Med

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“…Unfortunately, the presence of renal artery stenosis does not necessarily imply that it is the cause of hypertension. A 50% stenosis is often considered significant, although perfusion pressure in a large artery may not be affected until stenosis exceeds 70% [22]. Essentially, the only way to judge its significance is to treat the stenosis and see if blood pressure falls [4,22].…”

Section: Discussionmentioning

confidence: 99%

Captopril scintigraphy in the study of arterial hypertension in pediatrics

Lagomarsino

Orellana

Muñoz

et al. 2004

Pediatric Nephrology

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Renovascular hypertension (RVH) is responsible for 10% of arterial hypertension in children. The early diagnosis of RVH permits specific treatment leading to the cure of hypertension and avoidance of parenchymal damage. Captopril renal scintigraphy (CRS) provides information on the renovascular cause of the arterial hypertension. To validate the usefulness of CRS in hypertensive children, clinical, scintigraphic, and radiological data from 20 patients (mean age 6.1+/-5.5 years) were reviewed. Two patients were newborns. All had renal ultrasound scans and 9 had aortograms. In 7 children, RVH was confirmed by angiography, and CRS was positive for RVH in 6 of these. CRS was negative for RVH in 12 of 13 children without RVH. CRS was non-diagnostic in 3 children with abnormal baseline renal scintigraphy and severely decreased relative renal function ( <35%), 1 of whom had RVH. No side effects of captopril renography were observed. Captopril renography provides a logical, non-invasive, safe, and cost-effective approach in the evaluation of children suspected of having RVH.

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“…Despite its variable sensitivity, pre-and post-captopril renal scintigraphy is widely used to detect renal artery stenosis in adults [26][27][28][29]. There is scant experience in the paediatric population, and the data are limited in children [21,28].…”

Section: Discussionmentioning

confidence: 99%

Reno-vascular hypertension in childhood: a nationwide survey

et al. 2007

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Renovascular disease accounts for 8-10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately 1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls, 18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure (18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia (2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu's arteritis; six (13%) neurofibromatosis; two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in 16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease, especially Takayasu's arteritis, should not be underestimated in children with renovascular hypertension.

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

Cited by 55 publications

References 77 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

Captopril scintigraphy in the study of arterial hypertension in pediatrics

Reno-vascular hypertension in childhood: a nationwide survey

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