title: [Analysis of characteristics of renin, aldosterone and aldosterone/renin ratio in patients with aldosterone-producing adenoma].
abstract: OBJECTIVE
  To characterize the plasma renin activity (PRA) and plasma aldosterone concentration (PAC) and aldosterone/renin ratio (ARR) in patients with aldosterone-producing adenoma (APA).
  
  
  METHODS
  We retrospectively analysed the data of PRA, PAC and ARR from 80 patients with APA, 70 patients with essential hypertension (EH) and 26 individuals with normal blood pressure (NBP). Patients with hypertension were further divided into taking anti-hypertensive drug group (D) and non drug treatment group (ND). All participants received at least one following tests:ARR screening test, supine-upright position test and saline load test.Receiver-operating characteristic (ROC) analysis was used for exploring the best cut-off value of ARR and low PRA.
  
  
  RESULTS
  The median and percentages of PRA (ng×ml(-1)×h(-1), 1 ng×ml(-1)×h(-1) = 1 µg×L(-1)×h(-1)), PAC (ng/dl, 1 ng/dl = 27.7 pmol/L) and ARR (ng×dl(-1)/ng×ml(-1)×h(-1)) between NBP and EH (ND) groups showed no differences.Over 90% supine PRA ≥ 0.52 and 100% upright PRA ≥ 0.52 in the above two groups. On the contrary, 90% APA (ND) patients upright PRA <0.52. The lowest supine and upright ARR in APA (ND) patients was ≥ 24.2 and ≥ 37.5 respectively. ROC analysis suggested that the best screening cut-off values for APA were supine ARR ≥ 26.0, upright ARR ≥ 37.0; and low PRA cut-off value for APA were supine PRA <0.50 and upright PRA < 0.63 respectively. The sensitivity and specificity for APA diagnosis were about 88.2% and 61.5% when PAC ≥ 10.0 after saline load test.
  
  
  CONCLUSIONS
  The distinguishing features of PRA, PAC and ARR can be used as a diagnostic indexs for the exclusive diagnosis of APA in various clinical tests. And low PRA cut-off values exist in APA patients.
authors.affiliation: Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China.
authors.forename: Ye-bing
authors.initials: YB
authors.lastname: He
authors.forename: Xiao
authors.initials: X
authors.lastname: Yu
authors.forename: Xin-rong
authors.initials: XR
authors.lastname: Zhou
authors.forename: Bai-hua
authors.initials: BH
authors.lastname: Shu
authors.affiliation: Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan 430030, China. Email: jhliu@tjh.tjmu.edu.cn.
authors.forename: Ji-hong
authors.initials: JH
authors.lastname: Liu
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000450:Aldosterone / Q000097:blood*; D016022:Case-Control Studies; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood* / Q000473:pathology; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000450:Aldosterone; D012083:Renin