[An experience of single dose captopril renal scintigraphy in the diagnosis and management of bilateral renovascular hypertension].
A 41-year-old woman visited our hospital with chief complaint of hypertension which was refractory to multiple antihypertensive drugs. Her blood pressure was 200/140 mmHg and her plasma renin activity was as high as 3.1 ng/ml/hr. Angiography revealed bilateral renal artery stenosis. To determine the laterality of the kidney which were responsible for her hypertension, the 99mTc-DTPA renal scintigraphy with captopril was performed. The estimated GFR of the right kidney was lowered than that of the control, while there was no change in the left kidney. Subsequently Percutaneous Transluminal Angioplasty (PTA) was performed to the right kidney. Postoperatively blood pressure remained elevated as well as serum renin level. 99mTc-DTPA scintigraphy with captopril was repeated and revealed no decrease in the GFR of the right kidney this time, but significant reduction in the GFR of the left kidney. After the second PTA to the left kidney, her blood pressure was finally normalized. Postoperatively GFR of both kidneys was not affected by captopril on renal scintigraphy, and currently she has remained normotensive without medication. 99mTc-DTPA scintigraphy with captopril appears to be a useful method to diagnose the laterality and to evaluate in clinical response to therapeutic intervention.
Department of Urology, Hokkaido University, School of Medicine.
K
K
Kurisu
M
M
Togashi
M
M
Kitahara
H
H
Kakizaki
S
S
Nagamori
T
T
Koyanagi
D000328:Adult; D002216:Captopril; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D007668:Kidney / Q000000981:diagnostic imaging*; D015609:Organotechnetium Compounds; D004369:Pentetic Acid; D011877:Radionuclide Imaging; D016284:Technetium Tc 99m Pentetate
D015609:Organotechnetium Compounds; D004369:Pentetic Acid; D002216:Captopril; D016284:Technetium Tc 99m Pentetate