Renovascular hypertension: predicting surgical cure with exercise renography

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Nuclear Medicine

Background:

• Renovascular hypertension is a potentially curable condition.
• Exercise-induced renal hippurate transport abnormalities may indicate fixed hypertension.
• Predictive tools for renovascular hypertension outcomes are needed.

Purpose of the Study:

• To verify the predictive value of exercise hippurate scintigraphy for renovascular hypertension.
• To test if exercise-induced hippurate transport disturbances predict persistent hypertension post-operation.

Main Methods:

• Prospective study of 31 hypertensive patients with documented renovascular stenosis.
• Comparison of rest and exercise hippurate scintigrams.
• Analysis of blood pressure response to revascularization based on exercise scintigraphy results.

Main Results:

• 61% (19/31) of patients showed exercise-induced disturbances in renal hippurate transport (abnormal renogram).
• 39% (12/31) of patients had normal exercise renograms.
• 10/12 patients with normal exercise renograms were cured post-treatment, while 17/19 with abnormal renograms showed little improvement.

Conclusions:

• Exercise hippurate scintigraphy is a valuable tool for predicting renovascular hypertension outcomes.
• Abnormal exercise renograms indicate a poorer prognosis and less response to therapy.
• Normal exercise renograms predict successful treatment and potential cure of hypertension.