Predictive value of Tc-99(m)-DTPA captopril scintigraphy in patients with a solitary kidney and reduced kidney function

The aim of this study was to determine if the qualitative Tc-99(m)-DTPA cap topril radionuclide test (CRT) can help predict the acute detrimental effec t of angiotensin-converting enzyme (ACE) inhibitors on renal function in hy pertensive patients with solitary kidneys and chronic renal failure. Betwee n 1991 and 1996, eight consecutive patients (6 males, 2 females) aged 27-73 years (mean 49.8 years) with known chronic renal failure and a solitary ki dney referred for ACE treatment were included. Tc-99(m)-DTPA renography was performed at baseline and 1 h after the administration of 25 mg captopril within 1 week of each other. The CRT was performed in accordance with the c riteria of the Working Party on the Diagnostic Criteria of Renovascular Hyp ertension with Captopril Renography. A beneficial or detrimental effect of subsequent ACE inhibitor treatment on renal function was determined by long -term follow-up (greater than or equal to 2 years). The CRT accurately pred icted outcome in all eight patients subsequently treated with ACE inhibitor s. rn conclusion, our results suggest a role for qualitative Tc-99(m)-DTPA CRT in the prediction of renal function in patients with a solitary kidney and chronic renal failure subsequently treated with ACE inhibitors. ((C) 19 99 Lippincott Williams & Wilkins).