Pre- and postcaptopril renal scintigraphy as a screening
testfor renovascular hypertension in children
Sameh Abdulsamea & Peter Anderson & Lorenzo Biassoni & Eileen Brennan &
Clare A. McLaren & Stephen D. Marks & Derek J. Roebuck & Sabry Selim & Kjell Tullus
S. Abdulsamea : S. Selim
Department of Paediatric Nephrology, Benha University Hospital,Benha, Egypt
P. Anderson : L. Biassoni : C. A. McLaren : D. J. Roebuck
Department of Paediatric Radiology,Great Ormond Street Hospital for Children NHS Trust,London WC1N 3JH, UK
E. Brennan : S. D. Marks : K. Tullus (*)
Department of Paediatric Nephrology,Great Ormond Street Hospital for Children NHS Trust,London WC1N 3JH, UK
e-mail: Tulluk@gosh.nhs.uk
Received: 5 May 2009 / Revised: 5 August 2009 / Accepted: 6 August 2009# IPNA 2009
Abstract: We studied the ability of pre- and postcaptoprilrenal scintigraphy to predict renovascular
disease (RVD) inchildren. Retrospective review of medical notes andradiology reports of all
hypertensive children who hadhad both pre- and postcaptopril renal scintigraphy with[99mTc]
dimercaptosuccinic acid (DMSA) and/or [99mTc]mercaptoacetyltriglycine (MAG3) and digital
subtractionangiography (DSA). 81 children aged 1–18 (median 10)years were studied with 62% (51)
having a diagnosis ofRVD. Main renal artery disease, intrarenal disease, and bothmain 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%, and51%, respectively. Pre- and postcaptopril
renal scintigraphywas unable to predict RVD in children.
Keywords Renal isotope . Angiography . Scintigraphy . Vascular . Hypertension . Stenosis