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Can Quantitative Renography Predict the Outcome of Treatment of Atherosclerotic Renal Artery Stenosis?

Department of Nuclear Medicine and Ultrasound and Medical Physics Department, Westmead Hospital, Westmead, Australia

Correspondence: For reprints contact: Simon M. Gruenewald, Dept. of Nuclear Medicine and Ultrasound, Westmead Hospital, Westmead, NSW, 2145, Australia.

ABSTRACT

The accuracy of quantitative gamma camera renography in predicting outcome of treatment was assessed in 31 patients with atherosclerotic renal artery stenosis. Glomerular filtration rate, renal perfusion, relative renal function, and mean parenchymal transit time were calculated before and after treatment (renal artery angioplasty or vascular surgery). Patients were also assessed during the follow-up period of up to 6 years. On the pre-treatment study, nine patients did not have prolongation of parenchymal transit time in the kidney on the side of the renal artery stenosis. Despite technically successful angioplasties, none of these patients showed a significant reduction in blood pressure or improvement in renal function. Twenty-two patients had prolongation of parenchymal transit time in the affected kidney. Three suffered complications of treatment, and the remaining 19 showed improvement in blood pressure control, reduction in parenchymal transit time, and improvement in relative renal function. Quantitative renography accurately predicted those patients who improved following intervention for atherosclerotic renal artery stenosis. On progress evaluation, patients with recurrent stenoses were easily identified.

FOOTNOTES

Presented in part at the 35th Annual Meeting of the Society of Nuclear Medicine, San Francisco, 1988.

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