What question did this study set out to answer?

To establish an effective aldosterone-to-renin ratio (ARR) threshold using active renin concentration for diagnosing primary aldosteronism.

Active renin versus plasma renin activity to define aldosterone-to-renin ratio for primary aldosteronism

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Randomized trial assesses active renin for screening primary aldosteronism, suggesting revised thresholds for diagnosis.

To establish an effective aldosterone-to-renin ratio (ARR) threshold using active renin concentration for diagnosing primary aldosteronism.
Measured plasma aldosterone concentration, immunoreactive renin concentration, and plasma renin activity in 36 hypertensive patients.
Compared ARR calculated from both immunoreactive renin and plasma renin activity.
Identified patients with adrenal adenomas based on specific ARR thresholds.
A significant correlation was found between plasma renin activity and immunoreactive renin (r=0.98, P<0.0001).
An ARR threshold of > 150 pmol/ng using immunoreactive renin was indicated for diagnosing primary aldosteronism.
Nine patients with increased ARR values had PAC > 650 pmol/l, and all were found to have adrenal adenomas.

Ferrari et al. (2004) studied this question.

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