[Captopril renography in the diagnosis of renovascular hypertension]

The value of renography before and after angiotensin converting enzyme inhibition with captopril (captopril renography) as a test for renovascular hypertension was studied in fourteen hypertensive patients. The captopril renography was performed with 99mTc-DTPA by means of a gammacamera, allowing determination of single kidney glomerular filtration rate (SKGFR). In all patients determination of renal vein plasma renin concentration and renal angiography were carried out. Eleven patients showed an elevated unilateral renin secretion. All of these had a significant decrease of SKGFR in one or both kidneys after captopril. Three patients without a lateralized renal renin secretion showed no change in SKGFR. In five patients with presumed essential hypertension there was no change in SKGFR during captopril renography. Captopril renography with 99mTc-DTPA gammacamera renography is a promising tool for identification of unilateral increased renin secretion in hypertensive patients suspected of renovascular hypertension.