elitoki
Forum Guru
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Captopril renal scan exactly, and how should I interprete this result?
Thanks
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| hanialkhadher
Forum Elite
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You do it when you suspect renal artery stenosis(severe hypertension, discripancy in size between the 2 kidneys , deteriorating renal function with or without captopril use,bruit in loin...) and before invasive procedures like angiogaraphy.
Give Radio active substance maesure renal uptake , then give Captopril and remeasure the uptake again, if decreased uptake after captopril(decrease GFR&RBF)--------> Renal Artery Steosis and treat it.
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"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
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| me007
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http://chorus.rad.mcw.edu/doc/01045.html
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| me007
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case with images
http://www.dhmc.org/webpage.cfm?site_id=2&org_id=...
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| elitoki
Forum Guru
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So, in HTN pte who I suspect renal artery stenosis, Do I have to order first USG and then Captopril renal scan?
 
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| GOGETA
I'm Dr. GOGETA
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good stuff
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As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
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| hanialkhadher
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elitoki wrote:So, in HTN pte who I suspect renal artery stenosis, Do I have to order first USG and then Captopril renal scan?
Yes, always start simpler then go for more expensive tests,
For example if you suspect patient to have an Aortic dissection , you can diagnose with MRI angiography , But if you have the choice pick Trasesophageal echo becouse it is faster and less expensive .
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"أقرأ بأسم ربك الذي خلق,خلق الأنسان من علق,أقرأ و ربك الأكرم, الذي علم بالقلم,علم الأنسان ما لم يعلم"
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| elitoki
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Thanks a lot~
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| me007
Forum Guru
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Renal artery stenosis usually has no symptoms. However the diagnosis is considered when there are clues such as:
- Blood pressure is unusually difficult to control, or new, or severe in a young person.
- There is a kidney damage without evidence of kidney inflammation, but in the presence of diseased arteries elsewhere, especially in the legs ( e.g. intermittent claudication, which often causes pain in the calves on walking). Signs of disease in the arteries can include a bruit (a sound with a stethoscope suggesting a narrowed artery), which may be heard over the abdomen in the case of renal artery stenosis.
- Kidneys are asymmetrical (one side shrunken, other side normal) on ultrasound or other kind of investigation. Kidney asymmetry can have other causes too though, such as reflux nephropathy.
The most accurate test is renal arteriography
- non-invasive tests include MRA and CT angiography
Ultrasound tests using Doppler techniques can occasionally be helpful. Uptake of some radioactive isotopes has been used in the past, but it is not as good as the techniques above.
http://renux.dmed.ed.ac.uk/EdREN/EdRenINFObits/RA...
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