Reversible diminished renal99mTc-DMSA uptake during converting-enzyme inhibition in a patient with renal artery stenosis
✍ Scribed by T. K. Kremer Hovinga; J. R. Beukhof; W. H. J. Luyk; D. A. Piers; A. J. M. Donker
- Publisher
- Springer
- Year
- 1984
- Tongue
- English
- Weight
- 313 KB
- Volume
- 9
- Category
- Article
- ISSN
- 0340-6997
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✦ Synopsis
A patient is described who had accelerated hypertension and unilateral renal artery stenosis, and who developed further deterioration in renal function during treatment with captopril, an angiotension-I (AI) converting-enzyme inhibitor. 99mTc-DMSA uptake was greatly diminished in the stenotic kidney, although renal blood flow and handling of 131I-hippurate was preserved. Uptake of 99mTc-DMSA in the affected kidney returned after substitution of captopril by the vasodilator minoxidil, while a comparable degree of blood pressure control was maintained. Thus, caution must be taken when interpreting results of 99mTc-DMSA scintigraphy in patients with proven or suspected renal artery stenosis treated with an AI converting-enzyme inhibiting drug. Moreover, our finding points to the importance of glomerular filtration in the renal handling of 99mTc-DMSA.