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Pre- and postcaptopril renal scintigraphy as a screening test for renovascular hypertension in children |
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| Authors: | Sameh Abdulsamea Peter Anderson Lorenzo Biassoni Eileen Brennan Clare A McLaren Stephen D Marks Derek J Roebuck Sabry Selim Kjell Tullus |
| Institution: | 1. Department of Paediatric Nephrology, Benha University Hospital, Benha, Egypt 2. Department of Paediatric Radiology, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH, UK 3. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, WC1N 3JH, UK |
| Abstract: | We studied the ability of pre- and postcaptopril renal scintigraphy to predict renovascular disease (RVD) in children. Retrospective review of medical notes and radiology reports of all hypertensive children who had had both pre- and postcaptopril renal scintigraphy with 99mTc] dimercaptosuccinic acid (DMSA) and/or 99mTc] mercaptoacetyltriglycine (MAG3) and digital subtraction angiography (DSA). 81 children aged 1–18 (median 10) years were studied with 62% (51) having a diagnosis of RVD. Main renal artery disease, intrarenal disease, and both main and intrarenal artery disease were present in 25, 14, and 12 patients respectively. The isotope study accurately diagnosed RVD, confirmed by DSA, in 47% (24 of 51) children, with eight false positive studies. The sensitivity, specificity, and positive and negative predictive values of the isotope study to predict RVD were 48%, 73%, 76%, and 51%, respectively. Pre- and postcaptopril renal scintigraphy was unable to predict RVD in children. |
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