Renal artery stenosis detection by combined Gates' technique and captopril test in hypertensive patients

A. Cuocolo, S. Esposito, M. Volpe, L. Celentano, A. Brunetti, M. Salvatore

Research output: Contribution to journalArticlepeer-review

Abstract

We studied 11 hypertensive patients by a radionuclide technique using Gates' method with [99Tc]DTPA to investigate the acute effects of captopril on glomerular filtration rate (GFR). Five patients had hypertension with unilateral renal artery stenosis (RAS) angiographically documented and six patients had essential hypertension (EH). Total and split GFR were determined under control conditions and after oral administration of captopril (50 mg). In the patients with RAS, captopril a significant decrease of GFR in the stenotic kidneys (from 42.4 ± 4 to 29.6 ± 3 ml/min, p <0.01), while no changes were observed in the nonstenotic kidneys (from 61.2 ± 3 to 61.6 ± 5 ml/min, NS). Total GFR was 103.6 ± 5 ml/min under control conditions and decreased to 91.8 ± 6 ml/min after captopril (p <0.05). No significant changes of GFR were detected after captopril administration in patients with EH. In a separate group of ten patients with EH, good correlation between 24-hr creatinine clearance and fractional uptake of [99mTc]DPTA was obtained. Good reproducibility of this radionuclide technique was also shown. This study demonstrates that the computed radionuclide GFR determination coupled with the captopril test allows one to unmask angiotensin II-dependent renal function and hemodynamic changes. This technique can be useful in clinical practice for identifying patients with renovascular hypertension.

Original languageEnglish
Pages (from-to)51-56
Number of pages6
JournalJournal of Nuclear Medicine
Volume30
Issue number1
Publication statusPublished - 1989

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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