EVALUATION OF HYPERTENSIVE PATIENTS WITH A SOLITARY KIDNEY USING CAPTOPRIL RENAL SCINTIGRAPHY WITH 99TCM-MAG3

The study aimed to evaluate the safety and reliability of captopril re nal scintigraphy (CRS) for diagnosing functionally significant renal a rtery stenosis (RAS) in hypertensive patients with a solitary kidney. Radionuclide studies were carried out using 100 MBq Tc-99m-mercaptoace tyl triglycine (MAG3), 1 h after administration of 50 mg captopril, an d repeated in baseline condition when abnormalities were observed in t he provocative study. Scintigraphic diagnosis of RAS was based on anal ysis of captopril-induced changes of the radiorenographs. Overall, 12 patients with a solitary kidney were investigated, and scintigraphic r esults compared to angiographic findings. All five patients with posit ive CRS showed an RAS >50%, whereas only one of the seven patients wit h negative CRS was affected by RAS. A significant fall in mean arteria l pressure was recorded after captopril administration (123 +/- 12 mm Hg before versus 108 +/- 11 after), but no serious side effects were o bserved. Our results demonstrate that captopril-induced modifications of the renogram could effectively be used to diagnose the presence of RAS. Captopril renal scintigraphy may therefore be suggested as a reli able and safe noninvasive approach to evaluate hypertensive patients w ith a solitary kidney.