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.

References

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