Predictive value of 99Tcm-DTPA captopril scintigraphy in patients with a solitary kidney and reduced kidney function.
The aim of this study was to determine if the qualitative 99Tcm-DTPA captopril radionuclide test (CRT) can help predict the acute detrimental effect of angiotensin-converting enzyme (ACE) inhibitors on renal function in hypertensive patients with solitary kidneys and chronic renal failure. Between 1991 and 1996, eight consecutive patients (6 males, 2 females) aged 27-73 years (mean 49.8 years) with known chronic renal failure and a solitary kidney referred for ACE treatment were included. 99Tcm-DTPA renography was performed at baseline and 1 h after the administration of 25 mg captopril within 1 week of each other. The CRT was performed in accordance with the criteria of the Working Party on the Diagnostic Criteria of Renovascular Hypertension with Captopril Renography. A beneficial or detrimental effect of subsequent ACE inhibitor treatment on renal function was determined by long-term follow-up (> or = 2 years). The CRT accurately predicted outcome in all eight patients subsequently treated with ACE inhibitors. In conclusion, our results suggest a role for qualitative 99Tcm-DTPA CRT in the prediction of renal function in patients with a solitary kidney and chronic renal failure subsequently treated with ACE inhibitors.
Van de Wiele
C
C
Department of Nuclear Medicine, University Hospital Gent, Belgium.
Brans
B
B
Vanholder
R
R
Hoeben
H
H
Van Laere
K
K
Dierckx
R A
RA
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D002216:Captopril / Q000009:adverse effects / Q000627:therapeutic use*; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy; D007668:Kidney / Q000000981:diagnostic imaging* / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging; D007677:Kidney Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000009:adverse effects; D016284:Technetium Tc 99m Pentetate / Q000009:adverse effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D019275:Radiopharmaceuticals; D002216:Captopril; D003404:Creatinine; D016284:Technetium Tc 99m Pentetate