Effects of renal artery reconstruction on kidney perfusion and tubular function measured by new radionuclide techniques

Therapeutic effects of renal artery reconstruction on kidney perfusion and function were studied in 36 patients using new methods for analyzing radionuclide studies. Effective renal plasma flow, glomerular filtration fraction and parameters indicating perfusion and tubular transport improved significantly in patients with postoperative normalization of blood pressure. Patients with a patent renal artery on angiogram but without normalization of blood pressure showed an improvement of parameters such as effective renal plasma flow, glomerular filtration fraction and tubular transport time, whereas the perfusion index remained unchanged. In the group with re-stenosis or re-occlusion all parameters deteriorated after surgery. Discriminant analysis of preoperative data showed that success of surgery could be predicted with high degree of certainty (65%) for improvement and 92% for no improvement). The results indicate, that radionuclide methods and arteriography are complementary in the evaluation of the hemodynamic consequences of a renal artery stenosis. They also help to assess the effects of reconstructive surgery and to predict operative success.