THE PYELOGRAM UREA WASHOUT TEST IN THE EVALUATION OF RENOVASCULAR HYPERTENSION

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Abstract
The pyelogram urea washout test (PUWT) was performed in 96 hypertensive patients who had sufficient clinical and laboratory data for meaningful retrospective analysis. Seventy-six patients had negative PUWTs. At least one other negative test (usually aortography) confirmed the negative washout test in each. Eleven patients had unilaterally positive tests and in 9 of these there was excellent correlation with split function studies, renal arteriography or results of surgery. In the remaining 2 there was no evidence of renovascular hypertension (false positives). Since there were no false negative tests, the PUWT seems to be well suited as one of the screening tests to exclude the diagnosis of hypertension due to surgically correctable unilateral renal disease. Because of the occasional false positive test, renovascular hypertension should be confirmed by aortography. Split function studies or other tests should be performed if aortography is negative because of the possibility of unilateral pyelonephritis.

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