RATIONALE AND USE OF VASODILATED EXCRETORY UROGRAPHY IN SCREENING FOR RENOVASCULAR HYPERTENSION

¹ Assistant Professor of Pharmacology and Radiology.

The use of dynamic increases in renal size as determined by the technique of vasodilated excretory urography (VEU) is compared with modified rapid-sequence pyelography in a series of 250 hypertensives.

The physiologic constraints of contrast disparities in screening for significant renal arterial stenosis are discussed.

Normal and abnormal responses to VEU are defined as well as laboratory evidence that renal size and renal hemodynamic states are closely linked. Thus, changes in renal size elicited by vasodilators can be used to assess renal vasodilator reserve and, thereby, the presence or absence of significant stenosis. Size changes are shown to be more accurate than contrast or length disparities.

None of the kidneys that increased by 10 per cent or more had significant stenosis; all of the kidneys with significant stenosis increased by 5 per cent or less.

The use of VEU has many advantages in screening hypertensives for renovascular hypertension that is potentially curable.

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