Differential glomerular filtration rate in diagnosis of renovascular hypertension and follow-up of balloon angioplasty.
Two hundred nine hypertensive patients with high stimulated plasma renin levels were screened for renovascular hypertension using Tc-99m DTPA renal scintigraphy. Differential glomerular filtration rate (Diff-GFR) was obtained by integrating the area under the background-subtracted renogram of each kidney between 1 and 3 minutes. 50 patients who also had undergone selective renal angiography were divided into four groups according to Diff-GFR contribution by one of the kidneys. If one kidney contributed 45-50% of total GFR, this was regarded as normal. A Diff-GFR of less than 45% was very considered to be very suggestive of renovascular hypertension in the appropriate clinical setting, while a Diff-GFR of less than 20% indicated that the renal artery might not be amenable to successful balloon angioplasty. Diff-GFR following balloon angioplasty closely reflected the early clinical response of the patients--and in some cases progressive Diff-GFR improvement was observed several months later. Diff-GFR as a scintigraphic criterion for renovascular hypertension has a sensitivity of 93%, specificity of 74%, and accuracy of 85%.
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon; D005919:Glomerular Filtration Rate; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000628:therapy; D004369:Pentetic Acid / Q000627:therapeutic use; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000628:therapy*; D013667:Technetium / Q000627:therapeutic use; D016284:Technetium Tc 99m Pentetate
D013667:Technetium; D004369:Pentetic Acid; D016284:Technetium Tc 99m Pentetate