Introduction: Whereas involvement of coronary, cerebral and lower extremity arteries is in the main focus of professional interest, atherosclerosis of renal arteries remains frequently omitted. However, hemodynamically significant renal artery stenosis may accelerate renal failure in patients with preexisting nephropathy. In practice, it is essential to distinguish renal artery stenosis from renovascular hypertension and ischemic nephropathy. Methods: There are various imaging methods for the detection of renal artery stenosis. This review concentrates on the capabilities and limitations of dynamic renal scintigraphy with pharmacological intervention. The performance of the test and its interpretation is described in detail. Results: Interpretation of the test includes both images and curves. Sensitivity and specificity of the test alone is about 80%, it improves to 90% with the use of an angiotensin converting enzyme inhibitor. The most specific criterion is the change of the nephrogram. Conclusion: Dynamic renal scintigraphy with pharmacological intervention directly tests the renin-angiotensin system. Therefore, it is able to predict the therapeutic effect of revascularization with high accuracy.

        Key words: renovascular hypertension – dynamic renal scintigraphy – ACE inhibitor