Reach further, in an Open Access Journal Endocrinology, Diabetes & Metabolism Case Reports

ISSN 1470-3947 (print)
ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology

Published by BioScientifica
Endocrine Abstracts (2010) 22 P18 

The aldosterone renin ratio based on the plasma renin activity and the direct renin assay for diagnosing aldosterone-producing adenoma

GianPaolo Rossi1, Marlena Barisa1, GiovanBattista Desideri2, Claudio Letizia3, Mauro Maccario4, Alberto Morganti5, Gaetana Palumbo6, Anna Patalano7, Anna Realdi1, Elisabetta Roman1, Teresa Maria Seccia1 & Achille Cesare Pessina1

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The screening for primary aldosteronism (PA) is based on the aldosterone/renin ratio (ARR), which is calculated with the plasma renin activity (PRA) as denominator. A direct measurement of active renin (DRA) is being used as an alternative to PRA, but its diagnostic performance remains uncertain.

Aim of the study was to head-to-head compare the ARR based on PRA (ARR-P) to on DRA (ARR-D), at baseline and post-captopril, for identifying aldosterone-producing adenoma (APA) in a subset (251 patients) of the PAPY Study.

The area (AUC) under the ROC curves was employed for estimating the accuracy of ARR-D and ARR-P for identifying APA and for between tests comparison. PA was found in 13.2% patients, 6.4% of whom had APA and 6.8% idiopathic hyperaldosteronism (IHA); 218 (86.8%) had primary hypertension. The PRA and the DRA showed a weaker correlation at baseline (r=0.26, P<0.0001) and a stronger post-captopril (r=0.65, <0.0001). Both the ARR-D and the ARR-P were useful for identifying APA, as shown by AUC under the ROC curves (0.870±0.058 and 0.973±0.028, respectively) >0.50 (both P<0.0001); at a between-test comparison the ARRs did not differ significantly. For the ARR-D the optimal cut-off value for identifying APA was 27.3, remarkably similar to that previously determined for the ARR-P. Thus, the ARR-D represents a reasonable alternative to the ARR-P for detecting APA.

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