Pre- and postcaptopril renal scintigraphy as a screening test for renovascular hypertension in children.
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 [(99m)Tc] dimercaptosuccinic acid (DMSA) and/or [(99m)Tc] 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.
Abdulsamea
Sameh
S
Department of Paediatric Nephrology, Benha University Hospital, Benha, Egypt.
Anderson
Peter
P
Biassoni
Lorenzo
L
Brennan
Eileen
E
McLaren
Clare A
CA
Marks
Stephen D
SD
Roebuck
Derek J
DJ
Selim
Sabry
S
Tullus
Kjell
K
D000293:Adolescent; D015901:Angiography, Digital Subtraction / Q000379:methods; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002216:Captopril / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D017263:Technetium Tc 99m Mertiatide; D013997:Time Factors; D014463:Ultrasonography; D014567:Urography
D000806:Angiotensin-Converting Enzyme Inhibitors; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D002216:Captopril