Authors: Emel Ceylan Günay M Halil Öztürk Eser Lay Ergün Bülent Altun Bilge Volkan Salanci Ömer Uğur Barbaros Çil Baki Hekimoğlu Biray Caner
Publish Date: 2005/05/05
Volume: 32, Issue: 9, Pages: 1064-1074
Abstract
Radionuclide renography with angiotensin converting enzyme ACE inhibition plays an important role in the diagnosis of haemodynamically significant renal artery stenosis Angiotensin receptor antagonists inhibit the renin angiotensin system at different levels from ACE inhibitors by selectively blocking the binding of angiotensin II to AT1 receptors The AT1 angiotensin receptor antagonist losartan has recently been used clinically in the treatment of hypertension However the available data on the use of losartan with renography for the detection of renovascular hypertension are limited and contradictory The purpose of this prospective study was to compare the effectiveness of losartan renography and captopril scintigraphy in revealing renal artery stenosisA total of 61 renal units in 32 patients with hypertension were studied in two groups based on the losartan dosage 50 mg in group A and 100 mg in group B Group A consisted of 17 patients in whom 19 renal units had angiographically proven renal artery stenosis ≥50 In group B there were 15 patients in whom 20 renal arteries were stenotic All of the patients underwent three renographies baseline captopril renography and early losartan renography Early losartan renography was performed at 1 h after oral losartan administration in both groups In group B seven patients underwent additional losartan renography late losartan performed 3 h after oral losartan administration these patients composed group B1From our preliminary results we conclude that losartan is not superior to captopril renography for the detection of haemodynamically significant renal artery stenosis However a high dose 100 mg of losartan provided higher sensitivity than the lower dose 50 mg Late losartan scintigraphy provided similar diagnostic efficacy to early losartan renography
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