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Aldosterone/Renin in serum/plasma

Indications: - screening test for primary hyperaldosteronism Clinical significance: 1) initial screening for primary hyperaldosteronism consists of midmorning ambulatory plasma renin + plasma aldosterone in a normovolemic, normokalemic patient - screening positive if plasma aldosterone > 15 ng/dL, or - plasma aldosterone/renin activity ratio ratio aldosterone renin -> angiotensin-1 > 23 ng/dL ng/mL/hr (positive) > 23 ng/dL ng/mL/hr sensitivity of 97%, specificity of 94% > 67 ng/dL ng/mL/hr sensitivity of 100% * sensitivity for primary aldosteronism ranges from 10% to 100% * specificity ranges from 70% to 100% [3] Test interactions: - increases (false positives for primary hyperaldosteronism) - alpha-adrenergic receptor agonists - beta-adrenergic receptor antagonists - direct renin inhibitors - NSAIDs - decreases (false negatives for primary hyperaldosteronism) - ACE inhibitors - dihydropyridine calcium channel blocker - diuretic - mineralocorticoid receptor antagonists - spironolactone, eplerenone - serotonin reuptake inhibitors [2]

Related

aldosterone (Electrocortin, Aldocortin) angiotensin-1/renin activity in plasma renin; angiotensinogenase (REN)

General

analyte ratio

References

  1. Panel of 3 tests Laboratory Test Directory ARUP: 70073
  2. Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18. American College of Physicians, Philadelphia 2012, 2015, 2018
  3. Hung A, Ahmed S, Gupta A et al. Performance of the aldosterone to renin ratio as a screening test for primary aldosteronism. J Clin Endocrinol Metab 2021 Aug; 106:2423. PMID: 34008000 https://academic.oup.com/jcem/article-abstract/106/8/2423/6278133

Components

aldosterone in serum/plasma renin in plasma