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Stenosis and Renographic Characteristics in Renovascular Disease

Department of Internal Medicine, University Hospital, Maastricht
Department of Radiology, St. Clara Hospital, Rotterdam
Department of Internal Medicine, St. Joseph Hospital Veldhoven, The Netherlands

Correspondence: For correspondence contact: P.W. de Leeuw, MD, Department of Internal Medicine, University Hospital Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands.

ABSTRACT

This study was designed to determine the degree of renal artery stenosis (RAS) which produces changes in renographic parameters. Methods: The angiographic severity of luminal narrowing in RAS was compared to ¹³¹I-hippuran renographic characteristics in 72 patients who had been selected for renal angiography because of suspected renovascular hypertension. Results: Significant differences in T_max, T_1/2 and counts under the curve to T_max were apparent at 30% of arterial luminal narrowing when stenotic and nonstenotic kidneys were compared. In patients with unilateral RAS, the difference in counts under the T_max curve between pairs of kidneys was also significantly different at 30% of stenosis. Patients with bilateral stenosis, on the other hand, could not be differentiated well from patients with essential hypertension because the T_max value on either side or the difference of T_max between the two kidneys and the values of the other parameters were similar, except for the difference in counts to T_max. Based on these findings it seems that bilateral RAS does not "mimic" unilateral stenosis in renographic terms, but rather, resembles a normal situation. Conclusion: Significant renographic changes can occur at 30% of arterial luminal narrowing in renal artery disease.

Key Words: renal artery stenosis • renography • minimal degree

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