captopril challenge test
{{Short description|Non-invasive medical test}}
__NOTOC__
{{Infobox diagnostic
| name = Captopril challenge test
| image = Image:Captopril skeletal.svg|right|thumb|
| alt =
| caption = Captopril chemical structure.
| pronounce =
| purpose =measures the change in renin plasma-levels
| test of =
| based on =
| synonyms =
| reference_range =
| calculator =
| DiseasesDB =
| ICD10 =
| ICD9 =
| ICDO =
| MedlinePlus =
| eMedicine =
| MeshID =
| OPS301 =
| LOINC =
}}
The captopril challenge test (CCT) is a non-invasive medical test that measures the change in renin plasma-levels in response to administration of captopril, an angiotensin converting enzyme inhibitor. It is used to assist in the diagnosis of renal artery stenosis. It is not generally considered a useful test for children,{{cite journal | last=Gauthier | first=B. | last2=Trachtman | first2=H. | last3=Frank | first3=R. | last4=Pillari | first4=G. | title=Inadequacy of captopril challenge test for diagnosing renovascular hypertension in children and adolescents | journal=Pediatric Nephrology | volume=5 | issue=1 | date=1991 | issn=0931-041X | pmid=2025535 | doi=10.1007/BF00852842 | pages=42–44}} and more suitable options are available for adult cases.
Procedure
Plasma concentration of renin is measured prior to and following the administration of captopril. The CCT is considered positive if the renin levels increase substantially or the baseline renin level is abnormally high.{{cite journal | last=Muller | first=F. B. | last2=Sealey | first2=J. E. | last3=Case | first3=D. B. | last4=Atlas | first4=S. A. | last5=Pickering | first5=T. G. | last6=Pecker | first6=M. S. | last7=Preibisz | first7=J. J. | last8=Laragh | first8=J. H. | title=The captopril test for identifying renovascular disease in hypertensive patients | journal=The American Journal of Medicine | volume=80 | issue=4 | date=1986 | issn=0002-9343 | pmid=3515933 | doi=10.1016/0002-9343(86)90819-3 | pages=633–644}}
=In adults=
CCT in adults is known to have high sensitivity, but a low specificity.{{cite journal | last=Bales | first=A. | title=Hypertensive crisis. How to tell if it's an emergency or an urgency | journal=Postgraduate Medicine | volume=105 | issue=5 | date=1999-05-01 | issn=0032-5481 | pmid=10335324 | doi=10.3810/pgm.1999.05.1.735 | pages=119–126, 130}}
Subtraction angiography is considered a more suitable test for renal artery stenosis in adults.{{cite journal | last=Svetkey | first=L. P. | last2=Himmelstein | first2=S. I. | last3=Dunnick | first3=N. R. | last4=Wilkinson | first4=R. H. | last5=Bollinger | first5=R. R. | last6=McCann | first6=R. L. | last7=Beytas | first7=E. M. | last8=Klotman | first8=P. E. | title=Prospective analysis of strategies for diagnosing renovascular hypertension | journal=Hypertension | volume=14 | issue=3 | date=1989 | issn=0194-911X | pmid=2670763 | doi=10.1161/01.hyp.14.3.247 | pages=247–257}}
See also
- Captopril suppression test - used to diagnose primary aldosteronism
References
{{reflist}}
{{Endocrine system procedures}}