The Use of Aldosterone-Renin Ratio as a Diagnostic Test for Primary Hyperaldosteronism and Its Test Characteristics under Different Conditions of Blood Sampling
| Autor: | Ying-Wai Ng, Fredriech K. W. Chan, Chiu-ming Ng, Cheung-Hei Choi, Sau-Cheung Tiu, Alice P. S. Kong, C C Shek |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_class Endocrinology Diabetes and Metabolism Clinical Biochemistry Essential hypertension Biochemistry Plasma renin activity chemistry.chemical_compound Endocrinology Internal medicine Hyperaldosteronism Renin Humans Medicine Aldosterone Aged Retrospective Studies Aged 80 and over Blood Specimen Collection Aldosterone-to-renin ratio business.industry Biochemistry (medical) Middle Aged medicine.disease Conn Adenoma ROC Curve chemistry Mineralocorticoid Female business Blood sampling |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 90:72-78 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2004-1149 |
| Popis: | Recent reviews recommended the use of the aldosterone/renin ratio (ARR) to screen for primary hyperaldosteronism. However, widely different cutoff levels have been proposed, and test characteristics of ARR under different conditions of sampling are not known. We conducted a retrospective review among 45 subjects with carefully validated diagnoses of primary hyperaldosteronism and 17 subjects with essential hypertension to study the utility of ARR. Sixty-two patients with 75 sets of plasma renin activity (PRA), aldosterone, and ARR values from a postural study and 48 sets of values from a saline suppression test were analyzed. Ninety-four percent of these subjects underwent investigations because of hypokalemic hypertension.ARR yielded larger areas under the curve in the receiver-operating-characteristics curve than PRA or aldosterone under all conditions of testing. Our results confirmed the superiority of ARR to either aldosterone or PRA alone as a diagnostic test for primary hyperaldosteronism.ARR cutoff levels were significantly affected by the condition of testing. Depending on posture and time of day, it varied from 13.1-35.0 ng/dl per ng/ml.h in our study population. When using ARR for screening primary hyperaldosteronism, posture and time of sampling should be standardized both within and between centers to minimize variability in cutoff levels. |
| Databáze: | OpenAIRE |
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