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In reply

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.

We also agree with Dr Mann's comment that the functional significance of 75% stenosis in an individual patient is unknown. This criterion was used in previous studies promoting CRS as a screening test,² however, and has also been used widely in the literature to . . . [Full Text of this Article]

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