CAPTOPRIL-INDUCED CHANGES IN EFFECTIVE RENAL PLASMA-FLOW IN HYPERTENSIVE RENAL-TRANSPLANT RECIPIENTS

The role of converting enzyme inhibitor enhanced radionuclide investig ations in post-transplant hypertension is not clearly defined. Presenc e of renal failure, chronic rejection and use of cyclosporin A complic ates the results. Captopril-induced changes in effective renal plasma flow (ERPF) were studied in 10 patients with severe post-transplant hy pertension and no evidence of rejection. Angiographic correlation was available in all. Six patients had a significant increase in ERPF afte r 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-in duced changes in ERPF can differentiate patients with native-kidney-in duced hypertension from those with hypertension secondary to transplan t renal artery stenosis in patients without evidence of rejection.