What drugs are contraindicated in renal artery stenosis?
Azotemia sets in when angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) cause efferent arteriolar dilatation, thereby decreasing intraglomerular pressure and filtration. Therefore, ACE inhibitors and ARBs are contraindicated in bilateral renal artery stenosis.
What is Lasix Renogram procedure?
The purpose of this test is to trace blood flow through the kidney. Its secondary purpose is to see how long it takes urine to pass out of the body. You will be given a small dose of a radioactive tracer through an intravenous (IV) line. Imaging will begin as the tracer is being injected.
What is a renal scan with Lasix?
A renal scan with Lasix evaluates the appearance and function of the kidneys. The test also detects kidney blockages (from kidneys to bladder) through images taken before and after the introduction of a diuretic (Lasix) to move urine through the kidneys.
What drugs should be avoided in bilateral renal artery stenosis?
Angiotensin-converting enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal artery stenosis due to risk of azotemia resulting from preferential efferent arteriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II.
Why are ACE inhibitors bad in renal artery stenosis?
In patients with RAS, ACE inhibitors prompt renal retention of the radiotracer due to decreased urinary output secondary to reduced GFR.
What happens during a renogram?
A renogram or renal scan is a test that uses a radioactive substance (or tracer) to examine your kidneys and their function. The scan evaluates the blood flow through the kidneys and measures the amount of time it takes for the tracer to move through the kidneys, collect in the urine and drain into the bladder.
How do you prepare Lasix renogram?
The amount of radiation used in this test is small and well within limits that are not harmful to you. This test is done in the Nuclear Medicine Department and lasts about 2 1/2 hours. There is no preparation you need to do for this test.
What is a NM renogram with Lasix?
What is a renogram with Lasix? This test looks at how the kidneys are working. Kidneys help filter waste from the body and produce urine. Lasix is a diuretic (a medicine that helps the kidneys produce urine more quickly).
What is diuretic renogram?
Diuretic renography involves the administration of a loop diuretic (eg, 0.5 mg/kg of furosemide) prior to radionuclide renal scanning or during IVP, while the latter involves percutaneous insertion of a catheter into the dilated renal pelvis, followed by fluid perfusion into the pelvis at a rate of 10 mL/min.
How is renography used to diagnose renal artery stenosis?
Asymmetry of DTPA uptake, time to peak uptake, or retention seen on a single post-captopril renogram is a highly sensitive and specific finding in detecting renal artery stenosis but does not distinguish unilateral from bilateral disease. If renograms are obtained both before and after captopril adm …
How big are kidneys with renal artery stenosis?
Renal artery stenosis/renovascular hypertension. Left, Sonograms of the kidneys on a 57-year-old woman with difficult-to-control hypertension shows kidneys of uneven sizes: The left kidney is 96 mm, and the right kidney is 63 mm.
How does captopril renography help diagnose renal artery stenosis?
Captopril renography in the diagnosis of renal artery stenosis: accuracy and limitations Asymmetry of DTPA uptake, time to peak uptake, or retention seen on a single post-captopril renogram is a highly sensitive and specific finding in detecting renal artery stenosis but does not distinguish unilateral from bilateral disease.
When to use ACE inhibitor scintigraphy for renal artery stenosis?
ACE inhibitor scintigraphy. the affected kidney with renovascular hypertension shows impaired function due to ACE inhibition; based on this principle scintigraphy has been very much useful for diagnosis of renal artery stenosis. performed by IV administration of enalapril maleate after 15 minutes.