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Exp Clin Endocrinol Diabetes 2007; 115(7): 433-438
DOI: 10.1055/s-2007-973061
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG · Stuttgart · New York

The Simultaneous Measurement of Plasma-Aldosterone- and -Renin-Concentration Allows Rapid Classification of all Disorders of the Renin-Aldosterone System

S. Diederich 1 , 2 , K. Mai 1 , V. Bähr 1 , S. Helffrich 2 , A. Pfeiffer 1 , F. H. Perschel 3
  • 1Dept. of Endocrinology, Diabetes and Nutrition, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
  • 2Endokrinologikum Berlin, Centre for endocrine and metabolism diseases, Berlin, Germany
  • 3Dept. of Clinical Chemistry and Pathobiochemistry, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
Further Information

Publication History

received 09.01.2007 first decision 07.02.2007

accepted 27.02.2007

Publication Date:
23 July 2007 (online)

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Abstract

Objective: The determination of the plasma aldosterone (PAC) to the plasma renin concentration (PRC) ratio is an accepted screening tool for primary hyperaldosteronism (PHyperA).

Design: To assess the diagnostic significance of this ratio for other disorders of the renin-aldosterone-system (RAS), 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®).

Results: Patients with PHyperA (n=31) had a PAC/PRC ratio between 105 and 2328 and could be distinguished without overlap from the essential hypertension group (ratio: range 2.7-49) and normal healthy volunteers (ratio: range 0.9-71). Fourteen patients with primary hypoaldosteronism showed low PAC/PRC ratios (range 0.21-0.98) and low PAC values (range: 42-100). Seven patients with secondary hypoaldosteronism had normal PAC/PRC ratios (range 2.8-23.2) and low PAC values (range: 42-116). Eight 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 differentiation of all major disorders of the RAS.

Conclusions: The measurement of PAC/PRC ratios using this automated system provides a sensitive and rapid screening method for PHyperA. Moreover, the measurement of both the PAC and the PAC/PRC ratio allows differentiation of other disorders of the RAS.

Key words

Plasma renin concentration - plasma aldosterone concentration - renin-angiotensin-aldosterone system - automated chemiluminescence assays

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Correspondence

Dr. S. Diederich

Endokrinologikum Berlin am Gendarmenmarkt

Centre for endocrine and metabolism diseases

Jägerstraße 61 (Q207)

10117 Berlin

Phone: +49/30/2091 56 31

Fax: +49/30/2091 56 11

Email: sven.diederich@endokrinologikum.com