RADIONUCLIDE RENOGRAPHY FOR DETECTION OF RENOVASCULAR HYPERTENSION AND PREDICTION OF THE CLINICAL-RESPONSE TO REVASCULARIZATION

The most frequently used non invasive tests in the diagnosts of renova scular hypertension are the measurement of peripheral blood renin befo re and after captopril administration, intravenous pyelogram, renal Do ppler examination and radionuclide renography without and with angiote nsin converting enzyme inhibitor administration. Measurement of renal vein renin levels and renal angiography are invasive tests commonly us ed. The latter allows an anatomical diagnosis of renal vein stenosis b ut does not give information about the functional consequences of such lesion and thus, does not predict the response of blood pressure to r evascularization. Radionuclide renography has become the most useful n on invasive diagnostic test, with a sensitivity and specificity of 83- 94 and 85-97% respectively. It also predicts clinical response to reva scularization and is useful for follow up after surgery or angioplasty . It also has good results in patients with renal failure, bilateral s tenosis or stenosis in a solitary kidney and in transplant patients.