succimer and Hypertension--Renal

Angiotensin converting enzyme (ACE) inhibitors has been suggested to halt the progression of chronic renal failure. As the initial step of a controlled trial of this hypothesis, it was investigated whether start of enalapril in patients with severe chronic nephropathy might cause a critical fall in their renal function. Thirty-one patients were studied, 26 on chronic antihypertensive treatment with drugs other than ACE inhibitors and 5 untreated normotensive. 51Cr-EDTA plasma clearance and renal technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scintigraphy were made before and 24 h after start of enalapril, mean dose 9 mg. Blood pressure fell from median 148/88 to 119/78 mmHg (p less than 0.01). Glomerular filtration rate (GFR) fell from median 14 to 12 ml/min/1.73 m2 (p less than 0.01). The median change in GFR was -14% (range -44% to +10%). The split renal function was unchanged and the scintigrams showed no intrarenal activity defects. In conclusion, enalapril caused a fall in GFR, which was clinically acceptable in most of the patients.

Topics: Adult; Aged; Blood Pressure; Clinical Trials as Topic; Diabetic Nephropathies; Enalapril; Female; Glomerulonephritis; Humans; Hypertension, Renal; Kidney Function Tests; Male; Middle Aged; Polycystic Kidney Diseases; Succimer

Post-transplant hypertension can be a diagnostic dilemma. In a select population of pediatric patients, in whom other diagnostic methods failed to reveal an abnormality, renal cortical SPECT imaging, using either Tc-99m GH or Tc-99m DMSA, revealed information that was not apparent on conventional planar renal scintigraphy. Abnormalities detected by this methodology included unsuspected renal infarct and areas of segmental perfusion deficit. The authors conclude that this methodology is a valuable tool in the evaluation of post renal transplantation hypertension in pediatric patients.

Topics: Adolescent; Adult; Child; Female; Humans; Hypertension, Renal; Kidney Cortex; Kidney Transplantation; Male; Organotechnetium Compounds; Postoperative Complications; Succimer; Sugar Acids; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon

The 99mtechnetium dimercapto-succinic acid scan provides an image of functional renal parenchyma. This static scan has specific indications and cannot be used simply in place of a 99mtechnetium diethylenetriaminepentaacetic acid scan. The major clinical indications for this investigation are the detection and/or evaluation of a renal scar, the small or absent kidney, an occult duplex system, certain renal masses, systemic hypertension or suspected vasculitis. The physiology of the 99mtechnetium dimercapto-succinic acid scan is reviewed briefly.

Topics: Child; Humans; Hypertension, Renal; Kidney; Kidney Diseases; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Topics: Child; Child, Preschool; Female; Humans; Hypertension, Renal; Infant; Kidney; Kidney Function Tests; Male; Pentetic Acid; Radiation Dosage; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Urinary Bladder; Urinary Tract Infections; Vesico-Ureteral Reflux

Renal scintigraphy with technetium Tc 99m succimer (DMSA) and technetium Tc 99m pentetate (DTPA) was used to study 80 hypertensive pediatric and adolescent patients. Renal abnormalities such as asymmetry of function, size, or shape were identified in 13 patients. Both excretory urography and technetium Tc 99m pentetate studies were successful in detecting 54% of the abnormalities in patients studied; technetium Tc 99m succimer identified 92%. The accuracy of the latter was 96%, with a specificity of 97%. The ability of technetium Tc 99m succimer renal scintigraphy to identify accurately the presence or absence of renal abnormalities warrants its inclusion in the initial examination of pediatric and adolescent patients with hypertension.

Topics: Adolescent; Adult; Child; Child, Preschool; Diagnostic Errors; Evaluation Studies as Topic; Humans; Hypertension, Renal; Infant; Infant, Newborn; Male; Pentetic Acid; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Urography

Topics: Child; Female; Humans; Hypertension, Renal; Pyelonephritis; Radionuclide Imaging; Renal Veins; Renin; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Urography