The exercise renogram and its interpretation.
The exercise renogram is a rarely used diagnostic procedure, but it may visualize an exercise-induced change in renal function related to the pathophysiology of essential hypertension, which could greatly increase interest in this examination. The aim of this study was to demonstrate the interpretative approach and the terminology which is used to describe results of exercise renography, using a population of hypertensives with renovascular disease.


METHODS
We reviewed the examinations of 70 hypertensives who had supine renography as well as exercise renography with a 60-80 W work load. Forty-eight patients were examined with 99mTc-MAG3 and 22 with 131I hippurate. The renographic and angiography results were recorded as well as the antihypertensive drugs used and the site of vascular lesions.


RESULTS
Thirty-three hypertensives developed a bilateral-abnormal exercise renogram, which appears to be associated with primary hypertension. Eight individuals responded to exercise with a unilateral-abnormal exercise renogram, in a kidney behind a stenosis. Only 19 patients had a normal exercise renogram, and 10 had only one functioning kidney. Pathology recognized but unrelated to the intervention included nonfunctioning and small kidneys and pelvic retention.


CONCLUSIONS
Exercise renography's only indication is for recognition of pathology unique to hypertension, since other function disturbances were recognized in resting renograms.
Clorius
J H
JH
Department of Oncological Diagnostics and Therapy, German Cancer Research Center, Heidelberg, Germany.
Hupp
T
T
Zuna
I
I
Schmidlin
P
P
Denk
S
S
van Kaick
G
G
D000328:Adult; D000368:Aged; D005080:Exercise Test; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D007668:Kidney / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011866:Radioisotope Renography; D019275:Radiopharmaceuticals; D017596:Renal Plasma Flow, Effective; D017263:Technetium Tc 99m Mertiatide
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D007465:Iodohippuric Acid; D017263:Technetium Tc 99m Mertiatide