Captopril-induced changes in effective renal plasma flow in hypertensive renal transplant recipients.
The role of converting enzyme inhibitor enhanced radionuclide investigations in post-transplant hypertension is not clearly defined. Presence of renal failure, chronic rejection and use of cyclosporin A complicates the results. Captopril-induced changes in effective renal plasma flow (ERPF) were studied in 10 patients with severe post-transplant hypertension and no evidence of rejection. Angiographic correlation was available in all. Six patients had a significant increase in ERPF after captopril, and all had a negative angiogram. One patient on CsA with a negative angiogram had no change in ERPF. Three patients had a fall in ERPF, and all 3 had transplant renal artery stenosis. Captopril-induced changes in ERPF can differentiate patients with native-kidney-induced hypertension from those with hypertension secondary to transplant renal artery stenosis in patients without evidence of rejection.
Sud
K
K
Department of Nephrology, Christian Medical College and Hospital, Vellore, India.
Oomen
R
R
Jacob
C K
CK
Shastry
J C
JC
D000792:Angiography; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D002216:Captopril / Q000494:pharmacology*; D003937:Diagnosis, Differential; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000209:etiology*; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000150:complications; D017596:Renal Plasma Flow, Effective / Q000187:drug effects*
D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril