CAPTOPRIL RENOGRAPHY AND THE HYPERTENSIVE PENAL TRANSPLANTATION PATIENT - A PREDICTIVE TEST OF THERAPEUTIC OUTCOME

PURPOSE: To detect predictive accuracy of captopril renography in tran splant recipients with hypertension. MATERIALS AND METHODS: This prosp ective study was performed to evaluate findings on 18 renal scans acqu ired after administration of captopril (captopril renograms) in 14 tra nsplantation patients with new onset or poorly controlled hypertension . Captopril renography was not used to affect case management but to p redict response to angioplasty. RESULTS: Arteriograms were abnormal in 12 of 18 studies. In the six cases in which angiograms were normal, c aptopril renograms also were normal. In the 12 cases in which angiogra ms were abnormal, captopril renograms were normal in five and abnormal in seven. In the five cases in which renograms were normal, hypertens ion did not improve, although angioplasty was technically successful. In the seven with abnormal renograms, four patients underwent angiopla sty with excellent results. These patients had a significant (P <.05) decrease in diastolic blood pressure (-15 mm Hg) and in creatinine con centration (-0.4 mg/dL) compared with patients with normal renograms a nd abnormal angiograms. CONCLUSION: In this small population, captopri l renography appeared to be predictive of physiologically meaningful r enal artery stenosis.