Captopril Renal Flashcards
RP
Dose
Tc99m MAG3: 3-8 mCi
Boil for 10 minutes
Stable for 6 hours
Indications
Evaluate renal artery stenosis
Evaluate uncontrolled hypertension
Evaluate: flow, function, obstruction
Contraindications
Iodine contrast study on the same day
Patient still on ACE inhibitors
Patient still on angiotensin receptor blockers
Patient Prep
DC ACE inhibitors 3-7 days
Well hydrated
Peds must be cathed and may require saline drip
Drink at least 2 glasses of water prior to exam
NPO 4 hours
Check creatinine and BUN levels
Check patient blood pressure every 15 min
Positioning
Supine with camera ANT
Hand over scar please
Target Organ
Critical Organ
Method of Localization
Route of Excretion
Target Organ - Kidney
Critical Organ – Kidney/ bladder
Method of Localization: Compartmentalization
Route of Excretion – Urinary tract
Procedure
Phase 1: flow - 1-2 sec/ frame for 1 minute
Phase 2: function - 20-40 sec/frame for 20-30 minutes
Post Void Statics
Captopril Dose
Oral dose: 50 mg 1 hr prior to imaging
IV dose: 0.04 mg/kg 15 min before exam
Captopril Procedure
One day protocol
Low dose 1-3 mCi baseline study w/o captopril
Captopril study 2 hrs later w/ 5-10 mCi
Two day protocol
Stress done first
2 days later non captopril
If captopril study is normal day 1 – no day 2
Computer Set Up
LEHR
Renogram Analysis
Flow: 64x64
Function: 128x128
Normal
Visualize both kidneys at the same time
Activity in each kidney 50%
Peak concentration is 2-4 min post inj
Clearance t½ is 8-12 minutes
Captopril Values
Normal = 0 Mild = 1 Moderate = 2
RP
Dose
Tc99m MAG3: 3-8 mCi
Boil for 10 minutes
Stable for 6 hours
Abnormal
Treatment
Stent
Meds
