[Scintigraphy diagnosis of renovascular hypertension in renal transplanted patients].
Captopril renography (CR) has been shown to be a useful technique in the diagnosis of renovascular hypertension (RVH). This disease is a significant complication of the kidney transplanted patient so that early diagnosis would be extremely useful to preserve renal function and prevent graft loss. This work evaluates the role of CR, together with arteriography and doppler-ultrasound, in the diagnosis of RVH.


METHODS
A total of 19 transplanted patients with clinical suspicion of RVH underwent an isotopic study, a doppler-ultrasound study and an arteriography. Scintigraphy was performed 1 hour after a 50 mg dose of captopril, with oral hydration and i.v. administration of approximately 111 MBq of 99mTc-MAG3 and 20 mg of furosemide. If abnormal, a subsequent renography in baseline conditions was performed for comparison.


RESULTS
Overall, 11 patients had renovascular hypertension. Sensitivity and specificity of CR were 91% and 80% respectively, 100% and 60% for US and 91% and 100% for arteriography. The CR yielded one false positive result and 2 false negatives cases: one with 50% stenosis and one polar artery stenosis. Six patients were successfully dilated or operated.


CONCLUSIONS
CR seems to be a reliable diagnostic tool for the diagnosis of renovascular hypertension in kidney transplanted patients.
Lampreave
J
J
Servicio de Medicina Nuclear, Hospital General Gregorio Marañón, Madrid, 28028, España.
Rengel
M
M
Domínguez
P
P
Trampal
C
C
Ortega
A
A
Bittini
A
A
Almoguera
I
I
Pérez-Vázquez
J
J
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors; D002216:Captopril; D002404:Catheterization; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000628:therapy; D011237:Predictive Value of Tests; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012077:Renal Artery / Q000000981:diagnostic imaging; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000628:therapy; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide; D018608:Ultrasonography, Doppler
D000806:Angiotensin-Converting Enzyme Inhibitors; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide; D002216:Captopril