Conventional radionuclide renal scanning is not a suitable test or diagnosing renovascular hypertension (RVH) because of the high rate of false-negative and false-positive results observed in surgically-proven patients with RVH. Recently, the sensitivity and the specificity of renograms have been improved by performing the tests after pretreatment with captopril. It is unclear, however, whether renograms using different radiopharmaceuticals are equally useful. We therefore compared sodium-I-131-o-iodohippurate (HIP) and Tc-99m-diethylene-triamine-pentaacetic acid (DTPA) renal scintigraphy before and after a single oral dose of captopril. Our observations emphasize the value of HIP scintigraphy in evaluating patients with possible renovascular hypertension. The test may be specific by measuring the cortical retention of HIP after captopril pretreatment and may provide a uniquely sensitive indicator which is not shared by DTPA. Further experience is needed to assess the sensitivity of the test, particularly in patients with bilateral disease and patients with a branch stenosis of the renal artery. Its value in predicting normalization of blood pressure after angioplasty or corrective vascular surgery also needs assessment. So far, the results of HIP renography with and without captopril have correlated with the outcome of the hypertension in seven patients subjected to transluminal angioplasty of the renal artery.
|Original language||English (US)|
|Issue number||SUPPL. 25|
|State||Published - Jan 1 1988|
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