EXCRETORY UROGRAPHY IN RENOVASCULAR HYPERTENSION

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Abstract
None of the presently available urographic techniques provides more than strong suggestive evidence for the presence of renal artery stenosis causative of hypertension, Minute sequence urography is the most practical urographic technique available. It is easily performed as part of the routine excretory urogram. Barring urinary tract obstruction or severe unilateral parenchymal disease, a disparity in the time of appearance of the medium is strong evidence for functionally significant renal artery stenosis. Osmotic diuresis achieved with a nonreabsorbable osmotic diuretic agent (mannitol washout test) is of assistance in diagnosis in some cases, when the minute sequence urogram fails to demonstrate a disparity in the appearance time of the medium; but this examination is not a satisfactory substitute for separated renal function studies since both false-positive and false-negative results occur in a significant proportion of cases.

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