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Radiology, Vol 190, 153-159, Copyright © 1994 by Radiological Society of North America

ARTICLES

Captopril renography and the hypertensive renal transplantation patient: a predictive test of therapeutic outcome

KK Shamlou, WE Drane, IF Hawkins and RS Fennell 3rd
Division of Nuclear Medicine, Shands Hospital, Gainesville, FL.

PURPOSE: To detect predictive accuracy of captopril renography in transplant recipients with hypertension. MATERIALS AND METHODS: This prospective study was performed to evaluate findings on 18 renal scans acquired after administration of captopril (captopril renograms) in 14 transplantation patients with new-onset or poorly controlled hypertension. Captopril renography was not used to affect case management but to predict response to angioplasty. RESULTS: Arteriograms were abnormal in 12 of 18 studies. In the six cases in which angiograms were normal, captopril renograms also were normal. In the 12 cases in which angiograms were abnormal, captopril renograms were normal in five and abnormal in seven. In the five cases in which renograms were normal, hypertension did not improve, although angioplasty was technically successful. In the seven with abnormal renograms, four patients underwent angioplasty with excellent results. These patients had a significant (P < .05) decrease in diastolic blood pressure (-15 mm Hg) and in creatinine concentration (-0.4 mg/dL) compared with patients with normal renograms and abnormal angiograms. CONCLUSION: In this small population, captopril renography appeared to be predictive of physiologically meaningful renal artery stenosis.




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