Improved diagnosis of unilateral renal artery lesions after captopril administration
M. Thibonnier, A. Joseph, P. Sassano, T. T. Guyenne, P. Corvol, A. Raynaud, M. Seurot and J. C. Gaux
Captopril was administered (1 mg/kg of body weight) to 37 unselected
hypertensive patients undergoing bilateral renal vein catheterization to
determine its safety and efficacy in diagnosing hypertension related to
unilateral renal artery lesions. In the 18 patients who had a unilateral
renal artery lesion demonstrated by angiography, the ratio of plasma renin
activity of the involved to uninvolved renal vein rose significantly after
administration of captopril, whether or not patients were taking
antihypertensive medication. This postcaptopril ratio differentiated cases
of unilateral lesions from cases of bilateral lesions or absence of lesions
without any overlap. The test was well tolerated despite occasional large
drops in blood pressure. These data show that converting enzyme inhibition
increases the diagnostic accuracy of renal vein catheterization by
increasing the difference between the amount of plasma renin secreted by
the two kidneys in cases of unilateral renal artery lesions.
