Inhibition of angiotensin-converting enzyme for diagnosis of renal-artery stenosis.

Abstract

To determine its utility as an aid in diagnosis of renovascular hypertension, we administered nonapeptide converting-enzyme inhibitor (CEI) (which inhibits conversion of angiotensin I to angiotensin II) (0.25 mg per kilogram) to 14 unselected hypertensive patients undergoing bilateral renal-vein catheterization. In seven (Group I) predominantly unilateral disease was discovered by angiography (renal-artery stenosis in six and hydronephrosis in one); in the remaining seven (Group II) no rennal-artery abnormality was found. In Group I, mean (+/- S.E.) ratio of involved to uninvolved renal-vein plasma renin activity (PRA) increased from 2.94 +/- 0.91 before to 8.36 +/- 2.94 after CEI (P less than 0.01). In Group II, the ratio (of the initially higher to the lower side) was 1.99 +/- 0.49 before and 1.17 +/- 0.07 after CEI (P greater 0.02). Post-CEI PRA was predicted by pretreatment PRA. Mean blood pressure fell in both groups after CEI, and the decrement was predicted by pre-CEI PRA. These data suggest that CEI can be of use at the time of renal-vein catheterization, serving to increase diagnostic accuracy by increasing the difference in PRA between the two sides when there is unilateral disease.

• Authors: R Re, R Novelline, M T Escourrou, C Athanasoulis, J Burton, E Haber
• Journal: The New England journal of medicine (N Engl J Med) Vol. 298 Issue 11 Pg. 582-6 (Mar 16 1978) ISSN: 0028-4793 [Print] United States
• PMID: 203850 (Publication Type: Journal Article)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Renin

Topics

• Angiotensin-Converting Enzyme Inhibitors
• Blood Pressure (drug effects)
• Catheterization
• Humans
• Hydronephrosis (diagnosis)
• Hypertension, Renal (blood, diagnosis)
• Renal Artery Obstruction (blood, diagnosis)
• Renal Veins
• Renin (blood)