Screening for Renovascular Hypertension

Havey, Robert J.; Krumlovsky, Frank A.; delGreco, Francesco; Martin, H

doi:10.1001/jama.1985.03360030078027

Cited by 17 publications

(2 citation statements)

References 4 publications

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“…This observation may be of importance, since the specificity is reported to be approximately 77% for renography and 86% for IVU. 2 Therefore, further research in humans is necessary to evaluate these tests, especially with regard to their specificity.…”

Section: Discussionmentioning

confidence: 99%

Angiotensin converting enzyme inhibition improves diagnostic procedures for renovascular hypertension in dogs.

et al. 1988

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SUMMARY In renovascular hypertension adaptive mechanisms in the poststenotk kidney are a probable cause of the 20 to 25% false-negative findings during rapid sequence urography or [ 123 I]oiodohippurate renography. We blocked the renin-angiotensin system hi an effort to increase the yield of these diagnostic procedures. Chronically instrumented, salt-depleted conscious dogs were used hi which a light (n = 5), moderate (n = 4), or severe (n = 2) renal artery stenosis was induced. Before stenosis 10 of the dogs showed no left-right differences with either diagnostic procedure, and angiotensin converting enzyme (ACE) inhibition did not change this result. Two to 3 weeks after induction of a renal artery stenosis, all dogs showed signs of renovascular hypertension. However, only 50% of the renograms and 22% of the urograms showed differences between the two kidneys indicative of the presence of stenosis. After ACE inhibition, all previously negative test results became positive (abnormal) and previously existing left-right differences became more evident. Ekctromagnetically measured renal blood Bow on the stenotic side did not change during ACE inhibition (146 ± 13 vs 145 ± 21 ml/mm), whereas contralateral blood flow showed a distinct increase (207 ± 18 vs 282 ± 20 ml/min, p < 0.01).

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Section: Discussionmentioning

confidence: 99%

Angiotensin converting enzyme inhibition improves diagnostic procedures for renovascular hypertension in dogs.

et al. 1988

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“…The method has been in use for more than 30 years, and its ability to diagnose renal artery stenosis has at best reached sensitivity and specificity levels of c. 90% [26]. In our experience there are always abnormalities in the renograms in cases with a haemodynamically significant renal artery stenosis, provided that the urine flow rate is not too high at the examination [2 71.…”

Section: Renographymentioning

confidence: 99%