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What does my MRI scan report indicate?

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General & Family Physician
Practicing since : 2006
Answered : 2516 Questions
As part of a workup for moderate hypertension, presently well-controlled by drugs (see below) my bloodwork (which is otherwise normal, along with normal urinalysis and 24h urine) showed elevated plasma renin at 101 mg/L with an upright time of two hours. My family doctor thinks I might have a tiny renin-secreting adrenal adenoma, which as I understand is very rare, although the adrenal glands are normal on ultrasound and apparently kidneys are normal apart from tiny kidney stones, although there is a small perirenal cyst - apparently radiologist did not recommend follow-up. However, my doctor wants me to have an MRI to rule out an adenoma, but I am concerned about exposure to the Gadolinium contrast agent. Moreover, I was taking a calcium channel blocker (Norvasc 10mg) and and ACE inhibitor (2mg) for weeks before doing the plasma renin test, and I have read these drugs both elevate plasma renin. Should I ask him to take me off of these drugs and test plasma renin again to confirm the result before proceeding to an MRI? Thanks.
Sat, 14 Apr 2018 in Kidney Conditions
Answered by Dr. Albana Sejdini 7 hours later
Brief Answer:
If not took off first testing, ask for another one after taking off ACEinh.

Detailed Answer:

I have gone through your medical history carefully and understood your concerns.

I too agree with you. Ask your doctor to get you off ACE inhibitor for at least 2 weeks prior the testing ( best time is 4 weeks). Other meds like diuretics should get off too.

We do suspect adrenal tumor if renin level is low, and aldosterone is high. However potassium levels should be also get evaluated too.

If we confirm this after stopping the meds that affect renin levels, then we can proceed with MRI.

At the same time, your family doctor knows better your medical history, so perhaps we are missing something here.

You can send the tests results for further evaluation.

Hope this helps.

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