Captopril renography and duplex Doppler sonography in the diagnosis of renovascular hypertension |
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Authors: | Kaplan-Pavlovcic S; Nadja C |
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Institution: | Department of Nephrology, University Medical Centre, Zaloska 7, 1525 Ljubljana, Slovenia; Corresponding author |
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Abstract: | Background. The purpose of this prospective study was
to determine the clinical usefulness of captopril renal scintigraphy and
duplex Doppler sonography in detecting haemodynamically significant renal
artery stenosis (⩾60%) and predicting cure or improvement of
hypertension following revascularisation. Methods.
Twenty-eight patients with moderate or high index of clinical
suspicion of renovascular hypertension underwent both captopril renal
scintigraphy and duplex Doppler sonography before undergoing renal
angiography. Patients with angiographically proved (⩾60%) RAS were
treated by percutaneous transluminal renal angioplasty unless it was
contraindicated. Results. The results of captopril
renal scintigraphy and duplex Doppler sonography were compared by renal
angiography of 45 renal arteries in 28 patients. Eleven renal arteries were
excluded from further comparison, because no accurate Doppler signal could
be obtained. The sensitivity and specificity of captopril renal
scintigraphy in the identification of RAS (⩾60%) was 78% and 81%
respectively. The sensitivity of duplex Doppler sonography was 83% and the
specificity was 81%. Positive predictive values of both tests for blood
pressure cure or improvement after PTRA were 86% for CRS and 85% for DDS.
Conclusions. Captopril renal scintigraphy and duplex
Doppler sonography are comparable tests for detection of patients with
haemodynamically significant renal artery stenosis (⩾60%). Positive
predictive values of both tests for cure or improvement of hypertension
after percutaneous transluminal renal angioplasty are good and comparable. |
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