We appreciate Dr Mann's comments about the utility of captopril renal scans (CRS) for detecting RAS in clinical practice, and we agree that " . . . it would be a grave mistake to discard the test . . . ." Our article1 did not, however, suggest abandoning CRS. Rather, we suggested that CRS not be recommended as aninitial screening test for diagnosing RAS, but instead be used in patients who have known RAS (eg, positive results on magnetic resonance angiography or renal arteriography) for whom the physician is seeking additional information to support a decision about revascularization to improve blood pressure control.
Huot SJ, Concato J. Captopril Renal Scans for Detecting Renal Artery Stenosis—Reply. Arch Intern Med. 2003;163(5):630–631. doi:10.1001/archinte.163.5.630-a