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

 

作者: A.M. Peters,   P. George,   J. Brown,   J.P. Lavender,  

 

期刊: Nephron  (Karger Available online 1989)
卷期: Volume 51, issue 4  

页码: 470-473

 

ISSN:1660-8151

 

年代: 1989

 

DOI:10.1159/000185378

 

出版商: S. Karger AG

 

关键词: Filtration fraction;Renography;Hypertension;Angiotensin-converting enzyme;Renal blood flow

 

数据来源: Karger

 

摘要:

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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