Kutkuhn B, Hollenbeck M, Westhoff A, Ivens K, Heering P, Grabensee B
Department of Nephrology, Heinrich Heine University, Düsseldorf, FRG.
Urol Int. 1994;52(2):82-6. doi: 10.1159/000282579.
Basal renin secretion and the diagnostic value of a captopril stimulation (captopril test) in identifying renovascular hypertension secondary to transplant renal artery stenosis was assessed in 69 patients with hypertension after renal transplantation. An increase of plasma renin activity of 260% 1 h after captopril was considered as a positive result, assuming renovascular hypertension. Six of 69 patients had a positive captopril test, of these patients 5 had transplant renal artery stenosis. These patients were treated with percutaneous transluminal angioplasty (PTA) or surgery. Based on angiographic results and blood pressure response after PTA or surgery the captopril test showed a sensitivity of 100% and a specificity of 92% in the identification of hemodynamically significant stenosis of the transplant artery. Therefore, the captopril test provides a suitable screening instrument for the differential diagnosis of hypertension following renal transplantation.
对69例肾移植术后高血压患者评估了基础肾素分泌及卡托普利刺激试验（卡托普利试验）在鉴别移植肾动脉狭窄继发的肾血管性高血压中的诊断价值。假设为肾血管性高血压，卡托普利给药1小时后血浆肾素活性增加260%被视为阳性结果。69例患者中有6例卡托普利试验阳性，其中5例存在移植肾动脉狭窄。这些患者接受了经皮腔内血管成形术（PTA）或手术治疗。根据血管造影结果以及PTA或手术后的血压反应，卡托普利试验在识别移植肾动脉血流动力学显著狭窄方面显示出100%的敏感性和92%的特异性。因此，卡托普利试验为肾移植术后高血压的鉴别诊断提供了一种合适的筛查手段。
