The ratios of aldosterone / plasma renin activity (ARR) versus aldosterone / direct renin concentration (ADRR)

• Published in: Journal of the renin-angiotensin-aldosterone system Vol. 16; no. 4; pp. 1298 - 1305
• Main Authors: Glinicki, Piotr, Jeske, Wojciech, Bednarek-Papierska, Lucyna, Kruszyńska, Aleksandra, Gietka-Czernel, Małgorzata, Rosłonowska, Elżbieta, Słowińska-Srzednicka, Jadwiga, Kasperlik-Załuska, Anna, Zgliczyński, Wojciech
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.12.2015
• Subjects: Adult; Aged; Aldosterone - blood; Female; Humans; Hyperaldosteronism - blood; Male; Middle Aged; Renin - blood; Sensitivity and Specificity; Young Adult; direct renin concentration; plasma renin activity; DRC; Aldosterone; PRA; primary aldosteronism
• ISSN: 1470-3203; 1752-8976
• DOI: 10.1177/1470320313519487

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, r2 = 0.8165 (p < 0.01); and in the up-right position were r = 0.7765, r2 = 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.