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doc4mindia
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11/07/04 - 05:39 AM       #1

is captopril scan contraindicated in bilateral Renal artery stenosis?
why?


damacharla
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01/20/05 - 03:39 PM       #2

ACE inhibition prevents constriction of efferent arterioles. Therefore, the glomerular filtration rate is decreased in a kidney with afferent lesions and the renal scan looks WORSE.
Renal Perfusion Scan specifically offers information about blood flow to the kidneys which is normally compromised in renal artery stenosis. In order to look for renal artery stenosis, a Captopril (ACE Inhibitor) challenge renogram is performed, where an oral dose of captopril is given, and the a renal scan (or renogram) is obtained an hour later. Asymmetry in uptake (slow uptake due to renal artery stenosis on the affected side) and washout (slow washout of the radiotracer into the collecting system) indicate renal artery stenosis. If pt.has bil.RAS its difficult to diagnose.......finally this test is comparing the renal function between normal and abnormal kidneys ...so if both are abnormal..idont see a reason to do this test.I guess i answered ur question.


AAAAA
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05/01/06 - 09:17 AM       #3

We don't use captopril scan anymore.

Yes you can read about it but in real world, we don't use it.

It was used in late 1980 and early 1990. But 2006, we use angio to document the stenosis and stent. The internist may use it in the countryside but in major university center, this belongs to the museum !



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AAAAA
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05/19/06 - 06:56 PM       #4

We no longer use

Captopril Scan

in America !





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AAAAA
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05/21/06 - 02:18 AM       #5

We don't do captopril renograms because there are too many false negative and false positive.

Nowaday, we do MRA. magnetic resonance angiogram or CT-guided angiogram !

MRA with gadolinium


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AAAAA
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05/21/06 - 02:19 AM       #6

AAAAA wrote:
We no longer use


Captopril Scan


in America ! Instead, MRA has replaced captopril renogram






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d_raza1
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06/16/06 - 03:22 PM       #7

And captopril is contraindicated in bilateral renal artery stenosis (for Hypertension control for example)


AAAAA
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06/20/06 - 04:38 PM       #8

The moderator banned me from using bold letters.

Bilateral renal artery stenosis is very rare and I have not seen a case in 25 years. Thanks

I used to do captopril scan in 1980 but arteriogram is the gold standard for renal artery stenosis !


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