Comparison of plasma aldosterone measured by chemiluminescence immunoassay and liquid chromatography-tandem mass spectrometry in screening test for primary aldosteronism

• Published in: Practical laboratory medicine Vol. 39; p. e00361
• Main Authors: Chen, Wenzhan, Lai, Fenghua, Huang, Xiaoyu, Yu, Shuang, Chen, Nan, Xu, Changliu, Wang, Chenxue, Liang, Shuhui, Li, Yanbing, Xiao, Haipeng, Cao, Xiaopei
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2024; Elsevier
• Subjects: Chemiluminescence immunoassay; Liquid chromatography with tandem mass spectrometry; Original; Primary aldosteronism; Screening test; Chemiluminescence immunoassay; Primary aldosteronism; Screening test; Liquid chromatography with tandem mass spectrometry
• ISSN: 2352-5517; 2352-5517
• DOI: 10.1016/j.plabm.2024.e00361

Whether chemiluminescence immunoassay (CLIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) for plasma aldosterone concentration (PAC) measurement can be used interchangeably in primary aldosteronism (PA) screening is still controversial. The purpose of this study was to compare CLIA to LC-MS/MS for PAC measurement in PA screening. All participants underwent aldosterone-to-renin ratio (ARR) testing. PA was diagnosed by captopril challenge test or saline infusion test. PAC in screening test was measured with CLIA and LC-MS/MS. Plasma direct renin concentration in screening and confirmatory test was measured with CLIA. The concordance between CLIA and LC-MS/MS for PAC measurement in PA screening was analyzed. Twenty-one healthy volunteers, 61 patients with essential hypertension (EH) and 43 PA patients were enrolled. Median PAC by CLIA was 84.7 % higher than that by LC-MS/MS in screening test (P < 0.001). A positive correlation of PAC was observed between the two assays (Pearson r coefficient 0.770, P < 0.001). When ARR was used in differentiating PA from EH, there was no difference in the area under the receiver operating characteristic curve between CLIA and LC-MS/MS for PAC measurement (0.968 vs 0.950, P = 0.249). CLIA and LC-MS/MS for PAC measurement exhibited high and comparable efficacy in PA screening. CLIA is a reliable and feasible alternative in PA screening test. •PAC by CLIA was significantly higher than that by LC-MS/MS in screening test.•Positive correlations of PAC were observed between CLIA and LC-MS/MS assays.•CLIA and LC-MS/MS for PAC measurement exhibited high and comparable efficacy in PA screening.