Background The screening for primary aldosteronism is based on the aldosterone-renin ratio calculated with the plasma renin activity (PRA) value as denominator. A direct measurement of active renin (DRA) is being used as an alternative to PRA, but its diagnostic performance remains unclear. Method We, therefore compared, head-to-head, the aldosterone-renin ratio based on PRA with that based on DRA, at baseline and after captopril administration, for identifying aldosterone-producing adenoma (APA) in 251 patients of the Primary Aldosteronism Prevalence in hYpertension Study (PAPY). The area under the receiver operator characteristics curves was used for estimating the accuracy of the aldosterone-renin ratio based on either renin assay for identifying APA and for the comparison between tests. Results The rate of primary aldosteronism was 13.2%; 6.4% of the patients had an APA and 6.8% idiopathic hyperaldosteronism; 218 (86.8%) had primary hypertension. The area under the receiver operator characteristics curve for identifying APA was higher than 0.50 for the aldosterone-renin ratio based on both renin values (0.870 +/- 0.058 for DRA and 0.973 +/- 0.028 for PRA) (P<0.0001 for both) and did not differ significantly between the aldosterone-renin ratios calculated with either renin assay. For the aldosterone-renin ratio based on DRA, the optimal cutoff value for identifying APA was 27.3 ng/mlU, remarkably similar to that previously determined for the aldosterone-renin ratio based on PRA. Conclusion Thus, the aldosterone-renin ratio based on DRA is a valuable alternative to that based on PRA for detecting APA. J Hypertens 28:1892-1899 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
THE ALDOSTERONE RENIN RATIO BASED ON THE?PLASMA RENIN ACTIVITY AND THE DIRECT RENIN ASSAY FOR DIAGNOSING ALDOSTERONE-PRODUCING ADENOMA / Gian Paolo, Rossi; Marlena, Barisa; Anna, Belfiore; Giovambattista, Desideri; Claudio, Ferri; Letizia, Claudio; Mauro, Maccario; Alberto, Morganti; Gaetana, Palumbo; Anna, Patalano; Elisabetta, Roman; Teresa M., Seccia; Achille C., Pessina; Franco, Mantero; Papy Study, Investigators. - In: JOURNAL OF HYPERTENSION. - ISSN 0263-6352. - 28:A(2010), pp. E387-E388. (Intervento presentato al convegno 20th Annual Meeting of the European-Society-of-Hypertension tenutosi a Oslo, NORWAY nel JUN 18-21, 2010) [10.1097/hjh.0b013e32833d2192].
THE ALDOSTERONE RENIN RATIO BASED ON THE?PLASMA RENIN ACTIVITY AND THE DIRECT RENIN ASSAY FOR DIAGNOSING ALDOSTERONE-PRODUCING ADENOMA
LETIZIA, Claudio;
2010
Abstract
Background The screening for primary aldosteronism is based on the aldosterone-renin ratio calculated with the plasma renin activity (PRA) value as denominator. A direct measurement of active renin (DRA) is being used as an alternative to PRA, but its diagnostic performance remains unclear. Method We, therefore compared, head-to-head, the aldosterone-renin ratio based on PRA with that based on DRA, at baseline and after captopril administration, for identifying aldosterone-producing adenoma (APA) in 251 patients of the Primary Aldosteronism Prevalence in hYpertension Study (PAPY). The area under the receiver operator characteristics curves was used for estimating the accuracy of the aldosterone-renin ratio based on either renin assay for identifying APA and for the comparison between tests. Results The rate of primary aldosteronism was 13.2%; 6.4% of the patients had an APA and 6.8% idiopathic hyperaldosteronism; 218 (86.8%) had primary hypertension. The area under the receiver operator characteristics curve for identifying APA was higher than 0.50 for the aldosterone-renin ratio based on both renin values (0.870 +/- 0.058 for DRA and 0.973 +/- 0.028 for PRA) (P<0.0001 for both) and did not differ significantly between the aldosterone-renin ratios calculated with either renin assay. For the aldosterone-renin ratio based on DRA, the optimal cutoff value for identifying APA was 27.3 ng/mlU, remarkably similar to that previously determined for the aldosterone-renin ratio based on PRA. Conclusion Thus, the aldosterone-renin ratio based on DRA is a valuable alternative to that based on PRA for detecting APA. J Hypertens 28:1892-1899 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.