Captopril Renal Scan! - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
USMLE Articles
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam

Thread Tools Search this Thread Display Modes
Old 05-08-2010
USMLE Forums Scout
Steps History: Step 1 Only
Posts: 27
Threads: 11
Thanked 30 Times in 11 Posts
Reputation: 40
Urine Sample Captopril Renal Scan!

Can anybody tell me why do we have decreased GFR (decreased uptake) after giving captopril in patients with renal artery stenosis?

Isn't it that we actually give captopril for patients with renal artery stenosis as a mode of medical therapy!

Please explain for me
Reply With Quote Quick reply to this message

Old 05-08-2010
Ex-USMLE Forums Staff
Steps History: 1+CK+CS+3
Posts: 753
Threads: 106
Thanked 2,151 Times in 463 Posts
Reputation: 2199
Arrow About Captopril and Renal Artery Stenosis

The kidney in renal artery stenosis is hypoperfused and it depends much on angiotensin to maintain it's GFR by constricting the efferent. When you remove the effect of Angiotensin by giving an ACE inhibitor you'll take from the kidney it's precious way of preserving the GFR and therefore you diminish the GFR.

The effect of ACE inhibitors on the kidney is transient as the kidney eventually will overcome the problem by local metabolites therefore on the long term ACE inhibitors not only they don't affect renal function but in fact they are protective against further renal damage (by decreasing the intra-glomerular hypertension and thence decreasing proteinuria and glomerular damage). That's why ACE inhibitors are perfect for diabetic hypertensives as it will postpone the onset of diabetic nephropathy.

In renal artery stenosis, you don't jump right away to Captopril but rather the first choice is percutaneous angioplasty and if that fails then surgery and if that fails then you go to Captopril.

When you give Captopril to these patients, OK you'll reduce the renal function for a while but as I said that's temporary and not permanent. But Captopril is absolutely contraindicated in bilateral renal artery stenosis as it risks a serious renal shut down in the acute phase.
Reply With Quote Quick reply to this message
The above post was thanked by:
ath.pantelis (05-22-2010), docnok (09-08-2011), drZoe (05-14-2012), khushboo (05-22-2010), lynk (06-07-2010), mosallam (05-26-2010), RvpVip (07-20-2014)


Nephrology-, Physiology-

Quick Reply

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Please enter a password for your user account. Note that passwords are case-sensitive.
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Where you live. Leave blank if you don't want to tell.


Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.

Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Similar Threads
Thread Thread Starter Forum Replies Last Post
Ring Enhancement in Contrast Brain CT Scan rasheed USMLE Step 2 CK Buzzwords 1 06-27-2014 02:02 PM
Sestamibi Scan lee-usmle USMLE Step 2 CK Buzzwords 0 05-06-2010 07:30 PM
Best Renal Investigation? RRMadukha USMLE Step 2 CK Forum 3 04-26-2010 04:19 PM
Renal Cysts 3irfan USMLE Step 1 Bits & Pieces 0 11-27-2009 07:39 PM
Renal or Prerenal Sabio USMLE Step 1 Bits & Pieces 0 08-31-2009 09:16 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2016 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)