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      Filtration Fraction · Noninvasive Measurement with Tc-99m DTPA and Changes Induced by Angiotensin-Converting Enzyme Inhibition in Hypertension

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          Abstract

          Using a recently described new technique, individual kidney filtration fraction was measured from the first 3 min of the Tc-99m DTPA renogram in a series of 11 subjects without evidence of renal disease and in 23 patients with hypertension. Fourteen of these hypertensives had angiographic evidence of renal artery stenosis (RAS) but only 2 had proven renovascular hypertension (RVH). In addition, renal blood flow (RBF), expressed as a fraction of cardiac output, was measured from the first pass time activity curves following bolus injection of Tc-99m DTPA, and individual kidney glomerular filtration rate (IKGFR) was measured from the subsequent plasma Tc-99m DTPA clearance and renographic divided function. An estimation of filtration fraction based on these measurements of RBF and IKGFR correlated rather poorly with that directly based on the renogram, although both showed directionally similar changes in the hypertensive patients following inhibition of angiotensin-converting enzyme (ACE) with captopril. Filtration fraction by both estimates fell significantly after ACE inhibition in patients with RAS and essential hypertension, while RBF increased. IKGFR showed no change in essential hypertension or in hypertensive patients with RAS but fell sharply in 3 renal units in 2 patients with RVH. This renographic method for measuring filtration fraction is worthy of further elaboration and might be a simple and useful discriminator of RVH in a hypertensive population.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1989
          1989
          09 December 2008
          : 51
          : 4
          : 470-473
          Affiliations
          Departments of aDiagnostic Radiology and bClinical Pharmacology, Hammersmith Hospital, London, UK
          Article
          185378 Nephron 1989;51:470–473
          10.1159/000185378
          2500611
          © 1989 S. Karger AG, Basel

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          Page count
          Pages: 4
          Categories
          Original Paper

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