99mTc-DTPA TRANSPLANT RENOVASCULAR HYPERTENSION

            Male 33 year old,  underwent bank  kidney transplantation. Renogram performed with 99m Tc-DTPA. Kidney in right inferior abdominal quadrant with normal size. At baseline left, the kidney has adequate uptake and excretion, the bladder has significant contrast. After captopril, there is marked retention in the parechyma and minimal activity in the bladder.

            This pattern is typical after captopril, an ACE inhibitor (produces diminution of angiotensin II a vasoconstrictor and augmentation of bradykinin a vasodilator), and consequently induces a significant vasodilation in the efferent arteriole, transient drop of glomerular filtration and tracer retention.

References:

1   Etchebere, Elba, Ramos Celso Dario y Camargo, Edwaldo. Trasplante Renal. p: 425-433 en: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.

2   Hackländer T, Mertens H, Stattaus J, Lürken M, Lerch H, Altenburg A, Rautenbach J, Cramer BM. Evaluation of renovascular hypertension: comparison of functional MRI and contrast-enhanced MRA with a routinely performed renal scintigraphy and DSA. J Comput Assist Tomogr. 2004 Nov-Dec;28(6):823-31.

3   Acosta Gómez MJ, Llamas Elvira JM, Rodríguez Fernández A, Gómez Río M, López Ruiz JM, Muros De Fuentes MA, Moral Ruiz A, Ramírez Navarro A. Diagnosis of renovascular hypertension by pre- and post-captopril renal scintigraphy with 99mTc-DMSA. Rev Esp Med Nucl. 2001 Dec;20(7):537-43.

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