Inadequacy of captopril challenge test for diagnosing renovascular hypertension in children and adolescents.
A captopril challenge test (CCT) for renovascular disease in adults was described recently. We used it in 20 consecutive, untreated hypertensive children and adolescents. All had a normal urinalysis and glomerular filtration rate and non-diagnostic renal sonograms or intravenous urograms. Plasma renin activity (PRA) was measured before and 1 h after administration of captopril (0.76 +/- 0.17 mg/kg). The CCT was positive in 10 patients. Renal arteriograms were performed in 7 patients with a positive CCT and in 2 with a negative CCT. Renovascular disease was found in 4 patients, 1 of whom had a negative CCT. The PRA response to captopril was the same in patients with true- and the false-positive tests. The predictive value of the positive test was 43%. In conclusion, we did not find the CCT, as described for adults, to be of value in children and adolescents.
Gauthier
B
B
Schneider Children's Hospital of Long Island Jewish Medical Center, Long Island Campus of Albert Einstein College of Medicine, New Hyde Park, NY 11042.
Trachtman
H
H
Frank
R
R
Pillari
G
G
D000293:Adolescent; D000328:Adult; D002216:Captopril; D002648:Child; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis*; D008297:Male; D012083:Renin / Q000097:blood
D002216:Captopril; D012083:Renin