Evaluation of hypertensive patients with a solitary kidney using captopril renal scintigraphy with 99Tcm-MAG3.
The study aimed to evaluate the safety and reliability of captopril renal scintigraphy (CRS) for diagnosing functionally significant renal artery stenosis (RAS) in hypertensive patients with a solitary kidney. Radionuclide studies were carried out using 100 MBq 99Tcm-mercaptoacetyl triglycine (MAG3), 1 h after administration of 50 mg captopril, and repeated in baseline condition when abnormalities were observed in the provocative study. Scintigraphic diagnosis of RAS was based on analysis of captopril-induced changes of the radiorenographs. Overall, 12 patients with a solitary kidney were investigated, and scintigraphic results compared to angiographic findings. All five patients with positive CRS showed an RAS > 50%, whereas only one of the seven patients with negative CRS was affected by RAS. A significant fall in mean arterial pressure was recorded after captopril administration (123 +/- 12 mm Hg before versus 108 +/- 11 after), but no serious side effects were observed. Our results demonstrate that captopril-induced modifications of the renogram could effectively be used to diagnose the presence of RAS. Captopril renal scintigraphy may therefore be suggested as a reliable and safe noninvasive approach to evaluate hypertensive patients with a solitary kidney.
Fanti
S
S
Department of Nuclear Medicine, Policlinic S. Orsola-Malpighi, Bologna, Italy.
Dondi
M
M
Corbelli
C
C
Zagni
P
P
Bellanova
B
B
Franchi
R
R
Levorato
M
M
Fallani
F
F
Marengo
M
M
Fagioli
G
G
D000328:Adult; D000368:Aged; D002216:Captopril; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D007668:Kidney / Q000002:abnormalities*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D017263:Technetium Tc 99m Mertiatide
D017263:Technetium Tc 99m Mertiatide; D002216:Captopril