The importance of the perfusion index in the evaluation of captopril renography for transplant renal artery stenosis.
Severe renal artery stenosis (RAS) is a relatively uncommon complication following renal transplantation but is a curable cause of hypertension which demands reliable early diagnosis to reduce morbidity, mortality and graft loss. Captopril renography has been used for a number of years as a method of detecting RAS mainly in native kidneys, with only a few studies concerning the transplant situation. Controversy still exists as to the diagnostic accuracy of this test and as to the most appropriate interpretation criteria with which to establish a positive result. This paper reports the evaluation of 26 captopril renography investigations on hypertensive renal transplant patients with a suspected diagnosis of RAS. Each renogram study was correlated with an arteriogram as the 'gold standard' which was undertaken within 28 days of the renography. A sensitivity of 92%, a specificity of 86% and an accuracy of 88% were achieved by including a consideration of the change in perfusion to the kidney between pre- and post-challenge studies. It is concluded that captopril renography is a useful screening test for the detection of transplant renal artery stenosis (TRAS).
Mousa
D
D
Department of Renal Medicine, Riyadh Al Kharj Hospital Programme, Kingdom of Saudi Arabia.
Hamilton
D
D
Miola
U J
UJ
al-Sulaiman
M
M
Rassoul
Z
Z
Abdalla
A
A
Rehman
M A
MA
al-Khader
A
A
D002216:Captopril; D005069:Evaluation Studies as Topic; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation / Q000000981:diagnostic imaging*; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D011877:Radionuclide Imaging; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide; D016284:Technetium Tc 99m Pentetate; D013997:Time Factors
D017263:Technetium Tc 99m Mertiatide; D002216:Captopril; D016284:Technetium Tc 99m Pentetate