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Renovascular hypertension laboratory examination

Jan 04, 2017

Around 1. Plasma renin activity (PRA) Rudnick analysis report, such as peripheral blood PRA of renovascular hypertension diagnosis sensitivity of 57%, specificity of 66%.Muller PRA excitation test is put forward, such as taking enalapril 50 mg, PRA significantly increased after 1 h: 1) PRA acuity 12 ng/ml (h.);(2) increase of absolute value of PRA acuity 10 ng/ml · h);(3) PRA increase 150/100 or higher, the diagnostic sensitivity was 74%, specificity of 89%.Due to the high false positive diagnosis in this law, especially the foundation PRA level higher, more prone to false positives, so the current clinical basically do not use.

Renovascular hypertension laboratory examination

2. Points lateral renal venous renin activity ratio (RVRR) on both sides of normal renal vein PRA is increased by an average of 25% renal artery, if with bilateral renal venous blood PRA was higher than 50%, can be diagnosed with renal artery stenosis.Most scholars believe that RVRR > 1.5, the contralateral distal renal vein and inferior vena cava PRA is equal to the characteristics of the unilateral renal artery stenosis.Due to an increased lateral renal vein PRA, by feedback mechanism make the contralateral kidney secreted renin inhibition, therefore the PRA and distal inferior vena cava PRA are equal, but the actual is affected by various factors, is not absolutely equal, as long as the contralateral distal renal vein and inferior vena cava PRA ratios (RcCCR) < 1.3, (the contralateral renal vein PRA - inferior vena cava PRA)/inferior vena cava PRA (Rc - C/C) ratio < 0.24, reflecting the contralateral normal renal artery stenosis or no functional significance.In unilateral renal artery stenosis, RVRR 1.5 or higher accounted for 77%, the index to predict intervention or surgical success rate can reach 100%, but this law still has 50% false negative.In order to improve the positive rate, decrease false negative rate, using captopril proocation tests.Captopril 25 ~ 50 mg, in before taking the medicine and 60 min after taking medicine, renal venous blood samples were taken to determine PRA, and calculate the RVRR.Renin proocation tests have close relationship with sodium intake.Sodium intake more compatriots, reason of renin secretion inhibition, our study suggests that taking enalapril 60 min after 25 mg, RVRR > 2.5, diagnosed as positive, can make the RVRR diagnostic positive rate increased by 14% than before.Rossi, the said RVRR for renal artery occlusion with renal atrophy of renal artery stenosis patients will need to remove more diagnostic significance.In patients with bilateral renal artery stenosis, often only increased renal artery occlusion side PRA, differential diagnosis significance.

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