What question did this study set out to answer?

To determine whether captopril renography can unmask renin-angiotensin-mediated compensatory mechanisms and identify kidneys at risk of permanent deterioration due to junction obstruction.

October 1, 1998The Journal of Urology

The Captopril Renogram: A New Tool for Diagnosing and Predicting Obstruction in Childhood Hydronephrosis

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Authors

YHYves HomsyUniversity of South Florida BTBenjamin M. Tripp RLRaymond LambertCentre Hospitalier Universitaire Sainte-Justine

Discussion

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Implication

Prospective study reveals distinct functional response patterns during captopril renography in pediatric hydronephrosis, indicating impending renal impairment and guiding surgical intervention.

Key Points

To determine whether captopril renography can unmask renin-angiotensin-mediated compensatory mechanisms and identify kidneys at risk of permanent deterioration due to junction obstruction.
Prospectively evaluated 23 children (15 boys, 8 girls; mean age 3.5 years) presenting with grade III to IV hydronephrosis involving 19 suspected ureteropelvic and 9 ureterovesical junction obstructions.
Performed comparative assessments of differential renal function and glomerular filtration rate using standard diuretic renography and captopril renography, with follow-up extending through 1.5 years.
Captopril administration revealed 4 distinct functional patterns: unilateral decrease (5/23), bilateral decrease (2/23), bilateral increase (4/23), and no change (12/23).
Among 8 cases with severe drainage delays (half-time >20 minutes), captopril revealed an ipsilateral decrease in glomerular filtration rate in 4, bilateral increase in 1, and no change in 3.
Surgical intervention was directed to the 4 patients who demonstrated both half-time >20 minutes and decreased differential function on captopril renography, whereas 12 of 23 patients (52%) showed no response and remained stable over 1.5 years.

Cite This Study

Homsy et al. (1998) studied this question.

synapsesocial.com/papers/6a70196835aa2c282ce16527 https://doi.org/10.1016/s0022-5347(01)62587-4

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Implication

Prospective study reveals distinct functional response patterns during captopril renography in pediatric hydronephrosis, indicating impending renal impairment and guiding surgical intervention.

The Captopril Renogram: A New Tool for Diagnosing and Predicting Obstruction in Childhood Hydronephrosis

Discussion

Member takes

Implication

Key Points

Cite This Study

The Captopril Renogram: A New Tool for Diagnosing and Predicting Obstruction in Childhood Hydronephrosis

Discussion

Member takes

Implication

Key Points

Cite This Study

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