Radiology, Vol 146, 657-661, Copyright © 1983 by Radiological Society of North America
Hydralazine and the tourniquet test in renal vein renin sampling: a comparison
AS Gomes, AR Sinaiko, L Tobian, JN Cohn, G Formanek and K Amplatz
A total of 36 salt-depleted patients with suspected renovascular
hypertension received intravenous hydralazine and 36 were subjected to the
tourniquet test at the time of renal vein renin sampling. Simultaneous
bilateral renal vein samples were obtained sequentially over 30 minutes.
Both measures resulted in an increase in renin secretion. The number of
patients showing a positive ratio (greater than or equal to 1.5) between
the angiographically abnormal kidney and the contralateral kidney increased
in both groups. In the hydralazine group, 47% had positive ratios at 0 min
compared with 80% following hydralazine administration. In the tourniquet
group, 53% had positive ratios at 0 min compared with 78% afterward. In
neither group did all patients have positive ratios throughout the entire
sampling period. Hydralazine produced a greater increase in renin, but more
variable results. It is concluded that salt depletion is inadequate for
detection of a pressor kidney, and an additional stress is required.
Multiple simultaneous samples should be obtained.
