Diagnostic role of radionuclide renography in patients with renovascular hypertension
Background. Arterial hypertension due to the pathology of the renal artery, according to recent years, is observed in 10–15 % of patients with hypertensive disease; in 30 % of patients, it has a nephrogenic origin. The purpose was to investigate the role of radionuclide renography in patients with renovascular hypertension based on a retrospective analysis of the renograms. Materials and methods. 677 patients with renovascular hypertension (395 women and 282 men) aged 16 to 75 years were examined using renography method. The latter is based on the intravenous administration of 131I-hippuran at a rate of 2.5 kBq/kg and continuous recording for 20 minutes of radioactivity level above the kidneys with the help of UR 1-1 renograph sensors. Results. Based on the results of the analysis of the obtained data, the main types of renograms in patients with different forms of renovascular hypertension were identified. The first type is characterized by unchanged indicators of the renogram of a healthy kidney and a significant decrease in the amplitude of the curve reflecting the function of the stenotic kidney. The second type is characterized by unmodified renographic curve from the healthy kidney and complete non-function of the affected kidney. The third type was observed with bilateral lesions of the kidneys or of the perineal arteries with predominance of unilateral functional disorders. Conclusions. In order to optimize the examination of patients with renovascular hypertension, radionuclide renography is advisable to use after visualizing stenosis of the renal artery on the angiogram. This approach significantly increases the diagnostic value of renography, transforming it from the screening method into a technique for the functional evaluation of pathological changes in both the renal artery and the kidney itself.
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