Key result
Aldosterone-renin concentration ratio doubles false-positive rates versus activity ratio during beta-blocker therapy.
Why the study?
Measurement of plasma aldosterone/renin ratio is key for diagnosing primary aldosteronism, but the diagnostic utility of plasma aldosterone/renin activity versus concentration ratios needed comparison.
Does the plasma aldosterone/renin concentration ratio compare favorably to the plasma aldosterone/renin activity ratio for evaluating the renin-aldosterone system across different clinical conditions?
Cross-Sectional (n=134)
Does the plasma aldosterone/renin concentration ratio compare favorably to the plasma aldosterone/renin activity ratio for evaluating the renin-aldosterone system across different clinical conditions?
The plasma aldosterone/renin concentration ratio yields a higher false-positive rate than the activity ratio in patients on beta-blockers, indicating that caution is needed when substituting concentration for activity in clinical practice.
Answers are grounded in this paper and cite their sources.
Requires caution substituting concentration for activity ratio in beta-blocker users; leaves open reliable interchangeability across conditions.
INTRODUCTION: Measurement of plasma aldosterone/renin ratio is the key step in the diagnosis of primary aldosteronism. AIM: The aim of the authors was to analyze and compare the diagnostic utility of plasma aldosterone/renin activity and plasma aldosterone/renin concentration ratios. METHODS: Plasma aldosterone and plasma renin activity were determined by radioimmunoassays and plasma renin concentration was measured by immunoradiometric assay in 134 subjects (80 women and 54 men, aged 46±15.5 years) including 49 healthy blood donors (control group), 59 patients with hypertension (25 treated and 34 untreated) and 26 patients with incidentally discovered adrenal adenomas. RESULTS: There was a weak correlation (r = 0.59) between plasma renin activity and plasma renin concentration in the lower range (plasma renin activity, 0.63±0.41 ng/ml/h; plasma renin concentration, 8.1±4.9 ng/l). Considering the cut-off value of plasma aldosterone/renin ratios determined in controls (plasma aldosterone/renin activity ratio, 30 ng/dl/ng/ml/h; plasma aldosterone/renin concentration ratio, 3.0 ng/dl/ng/l), high proportion of falsely positive results were found among patients on beta-receptor blocker therapy (plasma aldosterone/renin activity ratio, 22.2%; plasma aldosterone/renin concentration ratio, 44.4%) CONCLUSION: The widely used plasma aldosterone/renin activity ratio can only be replaced with plasma aldosterone/renin concentration ratio with precaution on different clinical conditions.
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Horváth et al. (2012) conducted a cross-sectional in Hypertension and adrenal adenomas (n=134). Plasma aldosterone/renin concentration ratio vs. Plasma aldosterone/renin activity ratio was evaluated on False positive rate among patients on beta-receptor blocker therapy. Plasma aldosterone/renin concentration ratio yielded a higher false positive rate than the activity ratio among patients on beta-blocker therapy.
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