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

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

Procedure

• 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.
• Registered nurse must administer the following medications.
• Administer IV 0.04 mg/kg enalaprit (Vasotec) with a maximum dose of 2.5 mg then wait ten minutes.
• Begin ACE inhibition scan. Inject 8 mCi 99m Tc MAG-3 followed immediately by 40 mg Furosemide (Lasix).