Renal Scan, Ace Inhibition

 

Indications

Evaluation of renovascular hypertension.

Contraindications

Patients with an initial blood pressure of less than 140 mm/Hg should not receive ACE inhibition. Hypotension with serious consequences may occur.

Radiopharmaceuticals

  • 99m Tc MAG-3 (10 mCi) intravenously, 2 mCi baseline,
  • 8-mCi ACE inhibition scans.

Pharmaceutical

  • Enalaprilat (Vasotec) 0.04 mg/kg (2.5 mg maximum)
  • Furosemide (Lasix) 40 mg

Patient Preparation

  1. Patient should have blood pressure meds discontinued 24-48 hours prior to scan.
  2. Patient should be properly hydrated.
  3. Establish an intravenous infusion of normal saline at the rate of 4 ml/min.

Procedure

  1. Blood pressure monitored to assure systolic pressure above 140 mm/Hg. Blood pressure to be monitored and recorded every five minutes post injection of Vasotec and continued monitoring for 30 min per Registered Nurse.
  2. Registered nurse must administer the following medications.
  3. Administer IV 0.04 mg/kg enalaprit (Vasotec) with a maximum dose of 2.5 mg then wait ten minutes.
  4. Begin ACE inhibition scan. Inject 8 mCi 99m Tc MAG-3 followed immediately by 40 mg Furosemide (Lasix).

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