[Assessment of split renal function before and after angioplasty or bypass grafting in the patients with renovascular hypertension].
Two different methods to assess the change of split renal function following angioplasty or bypass grafting were studied in a total of 12 patients with renovascular hypertension. The studies were performed before and within seven days after the therapeutic intervention. Split effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) after injections of I-131 hippuran and Tc-99m DTPA were measured using kidney counting corrected for depth and dose, described by Schlegel and Gates. In six of 10 patients with unilateral renal artery stenosis and in two patients with bilateral renal artery stenoses (two of 4 affected kidneys), the split renal function was improved after the therapeutic intervention, in accordance with the drop in blood pressure and the reduction of plasma renin activity. The improvement in ERPF and GFR was more likely in the patients without severely reduced renal function. In such patients, the improvement in ERPF was more pronounced than that in GFR. And in two patients with functional improvement, the Captopril-induced reduction of split GFR in the affected kidney was disappeared after the intervention. Moreover, in the long-term follow-up of three patients with functional improvement, one patient showed the deterioration of split renal function suggesting the relapse of renal artery stenosis. These results suggest that the combined studies of split ERPF and GFR determinations can be useful to evaluate the therapeutic effect as well as the presence or absence of functional improvement after the intervention.
Aburano
T
T
Takayama
T
T
Nakajima
K
K
Seto
M
M
Tonami
N
N
Hisada
K
K
D000800:Angioplasty, Balloon; D005919:Glomerular Filtration Rate; D006801:Humans; D006978:Hypertension, Renovascular / Q000503:physiopathology* / Q000628:therapy; D012079:Renal Circulation