Radionephrographic follow-up with hypertensive patients after angioplasty of renal artery stenosis.
Radionephrographies were performed in 23 hypertensive patients before and after 28 transluminal dilatations (PTD) of their stenosed renal arteries. The changing clearances for both kidneys (global = Clgl) and for stenosed and contralateral kidneys (Clst and Clco) were followed for three groups, dependent on their clinical outcome, as well as the parenchymal transit time (re-entry time) for the diseased (Rtst) and contralateral kidneys (Rtco): (A) Normalized hypertension: for 9 patients the preoperative Clco was never lower than 150 ml/min, but increased significantly after PTD. Rtst fell significantly, Rtco remained constant. Mean increase in Clgl = 91 ml/min (+25%). (B) Improved hypertension: in 12 patients Clst and Clco had been lower than with those in group A; postoperatively Clst increased, Rtst fell significantly. The Rtco was prolonged early after PTD but normalized later. (C) Permanent hypertension: for 7 of these patients there were no preoperative criteria for a discrimination against the other groups. But in all Rtst did not normalize, and Rtco increased early after PTD. Even in later examinations Rtco remained higher than preoperatively. These results imply that the success of PTD depends mainly on the behavior of the contralateral kidney. The examination 1 day after the PTD gives an optimal prognosis concerning the end result.
Rösler
H
H
Thöni
A
A
Mahler
F
F
D000800:Angioplasty, Balloon; D001161:Arteriosclerosis / Q000000981:diagnostic imaging; D005352:Fibromuscular Dysplasia / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000628:therapy; D007465:Iodohippuric Acid; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000628:therapy; D012079:Renal Circulation
D007465:Iodohippuric Acid