[Renovascular hypertension. Radionuclide renography for detection and prediction of clinical response to revascularization].

The most frequently used non invasive tests in the diagnosis of renovascular hypertension are the measurement of peripheral blood renin before and after captopril administration, intravenous pyelogram, renal Doppler examination and radionuclide renography without and with angiotensin converting enzyme inhibitor administration. Measurement of renal vein renin levels and renal angiography are invasive tests commonly used. The latter allows an anatomical diagnosis of renal vein stenosis but does not give information about the functional consequences of such lesion and thus, does not predict the response of blood pressure to revascularization. Radionuclide renography has become the most useful non invasive diagnostic test, with a sensitivity and specificity of 83-94 and 85-97% respectively. It also predicts clinical response to revascularization and is useful for follow up after surgery or angioplasty. It also has good results in patients with renal failure, bilateral stenosis or stenosis in a solitary kidney and in transplanted patients.