title: The ratios of aldosterone / plasma renin activity (ARR) versus aldosterone / direct renin concentration (ADRR).
abstract: Primary aldosteronism (PA) is estimated to occur in 5-12% of patients with hypertension. Assessment of aldosterone / plasma renin activity (PRA) ratio (ARR) has been used as a screening test in patients suspected of PA. Direct determination of renin (DRC) and calculation of aldosterone / direct renin concentration ratio (ADRR) could be similarly useful for screening patients suspected of PA. The study included 62 patients with indication for evaluation of the renin-angiotensin-aldosterone system and 35 healthy volunteers. In all participants we measured concentrations of serum aldosterone, plasma direct renin, and PRA after a night's rest and again after walking for two hours. The concentrations of aldosterone, direct renin, and PRA were measured by isotopic methods (radioimmunoassay (RIA) / immunoradiometric assay (IRMA)). Correlations of ARR with ADRR in the supine position were r = 0.9162, r(2) = 0.8165 (p < 0.01); and in the up-right position were r = 0.7765, r(2) = 0.9153 (p < 0.01). The cut-off values of ARR and ADRR ≥ 100 presented highest specificity (99%) for the diagnosis of PA; however, quite acceptable specificity and sensitivity (> 80% and 100%, respectively) appeared for the ratios ≥ 30. We suggest that for practical and economic reasons ARR can be replaced by ADRR.
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland glinicki@cmkp.edu.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Glinicki
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Jeske
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Lucyna
authors.initials: L
authors.lastname: Bednarek-Papierska
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Kruszyńska
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Gietka-Czernel
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Rosłonowska
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Słowińska-Srzednicka
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kasperlik-Załuska
authors.affiliation: Department of Endocrinology, The Centre of Postgraduate Medical Education, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zgliczyński
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000450:Aldosterone; D012083:Renin
keywords: Aldosterone; DRC; PRA; direct renin concentration; plasma renin activity; primary aldosteronism