Captopril-enhanced renal scintigraphy in the diagnosis of pediatric hypertension

Reusz, György; Cseprekál, Orsolya; Szabó, Attila; Kis, Éva

doi:10.1007/s00467-009-1321-8

Cited by 12 publications

(5 citation statements)

References 38 publications

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“…391 -393 The utility of nuclear renography may be less in children then adults because children with RAS often have more complicated vascular abnormalities than adults. 394 Given these issues, nuclear renography has generally been abandoned as a screening test for RAS in children and adolescents. 390…”

Section: 8b Computed Tomographic Angiography Magnetic Resonance Anmentioning

confidence: 99%

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

et al. 2017

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These pediatric hypertension guidelines are an update to the 2004 "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents." Significant changes in these guidelines include (1) the replacement of the term "prehypertension" with the term "elevated blood pressure," (2) new normative pediatric blood pressure (BP) tables based on normal-weight children, (3) a simplified screening table for identifying BPs needing further evaluation, (4) a simplified BP classification in adolescents ≥13 years of age that aligns with the forthcoming American Heart Association and American College of Cardiology adult BP guidelines, (5) a more limited recommendation to perform screening BP measurements only at preventive care visits, (6) streamlined recommendations on the initial evaluation and management of abnormal BPs, (7) an expanded role for ambulatory BP monitoring in the diagnosis and management of pediatric hypertension, and (8) revised recommendations on when to perform echocardiography in the evaluation of newly diagnosed hypertensive pediatric patients (generally only before medication initiation), along with a revised definition of left ventricular hypertrophy. These guidelines include 30 Key Action Statements and 27 additional recommendations derived from a comprehensive review of almost 15 000 published articles between January 2004 and July 2016. Each Key Action Statement includes level of evidence, benefit-harm relationship, and strength of recommendation. This clinical practice guideline, endorsed by the American Heart Association, is intended to foster a patient- and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient diagnoses and outcomes, support implementation, and provide direction for future research.

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Section: 8b Computed Tomographic Angiography Magnetic Resonance Anmentioning

confidence: 99%

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

et al. 2017

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“…Following a 4-week baseline, patients with gestational hypertension were randomized to a double-blind treatment with captopril, prazosin, combined therapy or placebo once daily. Although previous results indicated that treatment with captopril or prazosin was able to regulate the plasma concentrations of vasodilation-converting enzyme and α-adrenergic receptor, respectively (19,31), to the best of our knowledge, the clinical outcomes of combined captopril and prazosin have not been investigated in previous studies. Therefore, the present study aimed to evaluate the clinical application of combined treatment with captopril and prazosin.…”

Section: Discussionmentioning

confidence: 87%

“…In addition, Van Guilder et al (30) have indicated that comprehensive effects of low-dose oral spironolactone and captopril therapy present more benefits for spontaneous hypertension and heart failure. Furthermore, Reusz et al (31) have recently suggested the influence of captopril treatment on occupational activity of engine operators with hypertension. These outcomes indicate that captopril is an efficient drug for the treatment of hypertension in preclinical and clinical experiments.…”

Section: Discussionmentioning

confidence: 99%

Combination treatment of captopril and prazosin to treat patients with gestational hypertension

et al. 2018

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Gestational hypertensive disorder is a complication of pregnancy, which adversely affects mother-child health. Captopril and prazosin are two agents that are frequently applied for the treatment of patients with gestational hypertension. However, the cooperative efficacy of captopril and prazosin has been not investigated in a previous study. In the present study, the comprehensive treatment of captopril and prazosin for the treatment of patients with gestational hypertension was investigated. A total of 324 patients with gestational hypertension were recruited to analyze the therapeutic effects of captopril and prazosin in patients with gestational hypertension. The duration of the treatment, dose-limiting toxicities and maximum tolerated dose of captopril and prazosin were examined in this cohort. Furthermore, the levels of blood pressure and proteinuria were also examined in patients with gestational hypertension who received treatment with captopril and/or prazosin with placebo as a control. Serum levels of vasodilation-converting enzyme and α-adrenergic receptor were also examined prior to and during the 4-week post-treatment period. It was observed that the most common treatment-emergence adverse events were hypertension and proteinuria following 4-week treatments. The data revealed that captopril or prazosin treatments significantly ameliorated gestational hypertension and symptoms compared with placebo (P<0.01). Notably, the combination of captopril and prazosin treatments significantly ameliorated hypertension and proteinuria and reduced the expression levels of vasodilation-converting enzyme and α-adrenergic receptor (all P<0.01), which contributed to beneficial effects on complications and blood coagulation mechanism compared with either captopril or prazosin treatment. In conclusion, the present clinical study indicated that combination treatment of captopril and prazosin exhibited more efficient outcomes than the single agent by improving gestational hypertension, indicating that a comprehensive therapeutic regimen of captopril and prazosin may be a potential clinical opinion for patients with gestational hypertension.

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“…The consequent dilatation lowers the glomerular transcapillary pressure, leading to a decrease in GFR. The decrease of the individual kidney GFR, induced by inhibition of ACE, can be evaluated by the captopril scintigraphy with the use of tubular agents, such as technetium-99m mercaptoacetyl triglycine (MAG3) or technetium-99m ethylenedicysteine (EC) or by glomerular agent, such as technetium-99m diethylene triamine penta-acetic acid (DTPA) 5 .…”

Section: Introductionmentioning

confidence: 99%

The role of a captopril renal scintigraphy in examination of children with hypertension: A case report

et al. 2018

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Introduction. Secondary hypertension is a relatively common form of hypertension in childhood with renovascular hypertension being responsible for 5%-10% of all arterial hypertensions in children. An early diagnosis of renovascular hypertension is important when considering an appropriate treatment of hypertension that may prevent or slow further progression of kidney damage. To validate the usefulness of a captopril renal scintigraphy in hypertensive children, we report a case of a 16-year-old female patient with a history of hypertension as a result of fibromuscular dysplasia. Case report. The patient was asymptomatic with elevated blood pressure revealed by a routine physical examination. Laboratory tests showed the increased levels of plasma renin activity with the normal levels of aldosteron. The renal ultrasound was normal. The Doppler of the renal arteries showed no significant differences of resistive index. A renal captopril scintigraphy was performed, including two day study protocol, the baseline study followed by another captopril study several days later. The scintigraphy showed the abnormal baseline and captopril renogram curve of the right kidney with significant cortical retention of radiotracer after angiotensin-converting enzyme inhibition. Following the captopril scintigraphy a renovasography was obtained confirming the presence of a 2 mm long circular narrowing of the right renal artery. It was immediately treated resulting in a significant expansion of the lumen. Conclusion. The captopril renal scintigraphy allows non-invasive functional testing in a selected group of hypertensive children, which can either confirm or rule out the existence of hemodynamically significant renal artery stenosis.

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Captopril-enhanced renal scintigraphy in the diagnosis of pediatric hypertension

Cited by 12 publications

References 38 publications

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents

Combination treatment of captopril and prazosin to treat patients with gestational hypertension

The role of a captopril renal scintigraphy in examination of children with hypertension: A case report

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