[Morpho-functional evaluation of hypertensive patients with renal artery stenosis. Correlations between angiography...

Renovascular hypertension is the most important and common cause of secondary hypertension. We studied 10 patients with arterial hypertension and different degrees of renal artery stenosis to assess the usefulness of dynamic radionuclide renography in evaluating renal perfusion and function, and to compare functional radionuclide results to the morphological findings of renal angiography. Computer-assisted dynamic renal imaging with 99mTc diethylenetriaminepentaacetic acid (DTPA) and 131I ortho-iodohippurate (OIH), and renal arteriography were also employed in all patients. In all patients, radionuclide results matched angiographic findings in quality. In particular, 3 patients with hemodynamically insignificant renal artery stenosis exhibited normal perfusion and function at dynamic radionuclide renography. Seven patients had significant renal artery stenosis and associated functional changes at dynamic radionuclide renography. Quantitative comparison of all patients showed a significant correlation (r = 0.866, p less than 0.001) between the degree of renal artery stenosis, quantified as the percentage of narrowing as compared to adjacent/contralateral normal vessel diameter, and the results of split renal function, as assessed during OIH studies and expressed per kidney as a percentage of the net total counts of both kidneys. In conclusion, our results demonstrated dynamic radionuclide renography to be a valuable tool in the assessment of functional changes secondary to renal artery stenosis in hypertensive patients, providing complementary results to arteriography.