Diagnostic use of angiotensin converting enzyme inhibitors in radioisotope evaluation of unilateral renal artery stenosis.
Iodine-123 hippurate renography, [99mTc]diethylenetriaminepentaacetic acid (DTPA) renography, and [99mTc]dimercapto succinic acid (DMSA) renal scintigraphy were performed before and during angiotensin converting enzyme (ACE) inhibition in a group of 15 hypertensive patients with angiographically "significant" unilateral renal artery stenosis. Visual and quantitative evaluation of the three radioisotope methods before ACE inhibition already disclosed abnormalities suggestive of renal artery stenosis in a high percentage (87%, 60%, and 60%, respectively) in this group of patients, but ACE inhibition further improved the diagnostic yield in all three methods (93%, 86%, and 80%). Iodine-123 hippurate renography was at least as useful as [99mTc]DTPA renography in this respect, while [99mTc]DMSA scintigraphy can be used particularly in segmental stenosis. Despite a large drop in blood pressure after ACE inhibition little adverse reactions were seen and overall renal function was fairly well maintained, the exceptions noted in patients with initially a more impaired renal function.
Kremer Hovinga
T K
TK
Department of Nephrology, University Hospital, Groningen, The Netherlands.
de Jong
P E
PE
Piers
D A
DA
Beekhuis
H
H
van der Hem
G K
GK
de Zeeuw
D
D
D000293:Adolescent; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors; D001794:Blood Pressure / Q000187:drug effects; D004341:Drug Evaluation; D004656:Enalapril; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000503:physiopathology; D007465:Iodohippuric Acid; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004113:Succimer; D013667:Technetium; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D016284:Technetium Tc 99m Pentetate
D000806:Angiotensin-Converting Enzyme Inhibitors; D009942:Organometallic Compounds; D007465:Iodohippuric Acid; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004656:Enalapril; D013667:Technetium; D004369:Pentetic Acid; D004113:Succimer; D016284:Technetium Tc 99m Pentetate