Active renin versus plasma renin activity to define aldosterone-to-renin ratio for primary aldosteronism

Details

Serval ID
serval:BIB_EE53E1170DBF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Active renin versus plasma renin activity to define aldosterone-to-renin ratio for primary aldosteronism
Journal
Journal of Hypertension
Author(s)
Ferrari  P., Shaw  S. G., Nicod  J., Saner  E., Nussberger  J.
ISSN
0263-6352 (Print)
Publication state
Published
Issued date
02/2004
Volume
22
Number
2
Pages
377-81
Notes
Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Feb
Abstract
BACKGROUND: In recent years, the assessment of the plasma aldosterone-to-renin ratio (ARR) has become an established screening method for the diagnosis of primary aldosteronism. Plasma renin activity (PRA) is usually measured to define ARR although, increasingly, renin concentration alone is often measured in clinical routine. OBJECTIVE: To determine the threshold of ARR using active renin concentration to screen for primary aldosteronism. DESIGN AND PARTICIPANTS: To determine the ARR threshold based on plasma immunoreactive renin concentration (irR), we measured plasma aldosterone concentration (PAC), irR and PRA in 36 hypertensive patients, nine thereof with adrenal adenoma, and compared ARRs calculated from irR and PRA, respectively. SETTING: Single-centre, hypertension clinic in a tertiary care hospital. RESULTS: PRA ranged from 0.41-14.9 ng/ml per h and irR from 1.1-72 ng/l. There was an excellent correlation between PRA and irR (r = 0.98, P < 0.0001) and between ARRPRA and ARRirR (r = 0.96, P < 0.0001). An ARRPRA > 750 pmol/l per ng/ml per h was previously found to be highly predictive of primary aldosteronism because 90% of the corresponding patients failed to suppress PAC upon saline infusion or fludrocortisone. The corresponding threshold value for ARRirR was 150 pmol/ng in our patients. Using these cut-offs, nine subjects had both increased ARRPRA and ARRirR while, in three patients, either ARRPRA or ARRirR were increased. The nine patients with increased ARRPRA and ARRirR also had PAC > 650 pmol/l. Only these patients had adrenal adenomas. CONCLUSIONS: The ARR threshold to screen for primary aldosteronism may be based on measurement of irR. An ARRirR > 150 pmol/ng may indicate primary aldosteronism.
Keywords
Adenoma/blood/metabolism Adrenal Gland Neoplasms/blood/metabolism Adult Aged Aldosterone/biosynthesis/*blood Differential Threshold Female Humans Hyperaldosteronism/*blood/*diagnosis Hypertension/blood Immunoradiometric Assay Male Middle Aged Osmolar Concentration Renin/*blood
Pubmed
Web of science
Create date
05/03/2008 17:40
Last modification date
20/08/2019 17:15
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