Article
The simultaneous measurement of plasma-aldosterone- and -renin-concentration allows the fast and exact classification of all disorders of the renin-aldosterone system
Die simultane Messung von Plasma-Aldosteron und -Renin erlaubt die exakte und schnelle Klassifikation aller Störungen des Renin-Aldosteron-Systems
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Published: | August 8, 2006 |
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The determination of the plasma aldosterone (PAC) to the plasma renin concentration (PRC) is meanwhile an accepted screening tool for primary hyperaldosteronism (PHA). To assess the diagnostic significance of this ratio for other disorders of the renin-aldosterone-axis (RAS) [Ref. 1], we examined 60 patients with different adrenal diseases, 32 patients with essential hypertension and 76 normotensive healthy volunteers. The aldosterone (pmol/L) and renin (mU/L) concentrations were measured in one plasma sample by an automated chemiluminescence assay (Nichols Advantage®) [Ref. 2]. Patients with PHA (n=34) had a PAC/PRC ratio between 105 and 2328 and were definitively to separate from the essential hypertension group (ratio: range 2.7 - 49) and normal healthy volunteers (ratio: range 0.9 -71). 14 patients with primary aldosterone deficiency are characterized by low PAC/PRC ratios (range 0.21 - 0.98) and low PAC values (range 42-100). 7 patients with secondary aldosterone deficiency showed normal PAC/PRC ratios (range 2.8 - 23.2) and low PAC values (range: 42 -116). 8 patients with secondary hyperaldosteronism had normal PAC/PRC ratios (range 7.8 - 67.9) and elevated PAC values (range: 803 - 2917). The graphic presentation of these data allowed the exact characterization of all disorders of the RAS. The measurement of PAC/PRC ratios with the used automated system is a sensitive and fast screening method for PHA (proposed cut-off value: > 105). Moreover, the determination of both the PAC and the PAC/PRC ratio allows differentiation of all other diseases of the RAS, especially in primary care centres.