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  • Title: Inadequacy of captopril challenge test for diagnosing renovascular hypertension in children and adolescents.
    Author: Gauthier B, Trachtman H, Frank R, Pillari G.
    Journal: Pediatr Nephrol; 1991 Jan; 5(1):42-4. PubMed ID: 2025535.
    Abstract:
    A captopril challenge test (CCT) for renovascular disease in adults was described recently. We used it in 20 consecutive, untreated hypertensive children and adolescents. All had a normal urinalysis and glomerular filtration rate and non-diagnostic renal sonograms or intravenous urograms. Plasma renin activity (PRA) was measured before and 1 h after administration of captopril (0.76 +/- 0.17 mg/kg). The CCT was positive in 10 patients. Renal arteriograms were performed in 7 patients with a positive CCT and in 2 with a negative CCT. Renovascular disease was found in 4 patients, 1 of whom had a negative CCT. The PRA response to captopril was the same in patients with true- and the false-positive tests. The predictive value of the positive test was 43%. In conclusion, we did not find the CCT, as described for adults, to be of value in children and adolescents.
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