ECE2023 Eposter Presentations Adrenal and Cardiovascular Endocrinology (124 abstracts)
Aldosterone/direct renin ratio (ADRR) in the screening of patients with primary aldosteronism
Alicja Szatko 1 , Dorota Leszczynska 1 , Barbara Badura 2 , Szymon Barczak 2 , Kinga Filipek 2 , Justyna Hempel 2 , Magdalena Ostrowska 1 , Lucyna Papierska 1 , Wojciech Zgliczyński 1 & Piotr Glinicki 1
1Centre of Postgraduate Medical Education, Department of Endocrinology, Warsaw, Poland; 2Centre of Postgraduate Medical Education, Students’ Scientific Group affiliated to the Department of Endocrinology, Warsaw, Poland
Background: Primary aldosteronism (PA) is the most common endocrine cause of secondary hypertension. It occurs in 5%-10% of hypertensive patients. PA is a group of disorders associated with semi-autonomous hypersecretion of aldosterone. Laboratory diagnosis in patients with suspected PA consists of screening tests aimed at determination of serum/plasma aldosterone concentration, direct renin concentration (DRC) and calculation of the aldosterone/direct renin ratio (ADRR). The aim of the study was to assess the usefulness of aldosterone and direct renin concentrations using the immunochemiluminescent method (CLIA, LIAISON XL® analyzer, DiaSorin, Italy) and to use the ADRR ratio as a screening test in the biochemical diagnosis of patients with suspected primary aldosteronism.
Methods: Patients were divided into 2 groups: 1. Patients with primary aldosteronism (n=35) 2. Patients with adenoma + hypertension (n=200) Serum aldosterone concentration, direct plasma renin concentration and aldosterone/DRC ratio (ADRR ratio) were determined in all patients. Aldosterone and direct renin concentrations were determined by immunochemiluminescent assay (CLIA) on a LIAISON XL® analyzer (DiaSorin, Italy). The ADRR is shown as ng/dl/µIU/ml.
Results: Serum aldosterone levels in patients with PA ranged from 9.92 to 100 ng/dl. Aldosterone levels were <10 ng/dl in 2 patients, between 10-15 ng/dl in 6 patients, and > 15 ng/dl in 27 patients. The optimal cut-off for aldosterone was 13.8 ng/dl (AUC 0.8816; P<0.0001). Sensitivity and specificity for serum aldosterone concentration for patients with PA were 79% and 82%, respectively. DRC in patients with PA was in the range of 0.5–10.1 µIU/ml. The optimal cut-off for DRC in patients with PA was 4.22 µIU/ml (AUC 0.9466; P<0.0001). Sensitivity and specificity for DRC were 83% and 94%, respectively. The aldosterone/renin ratio (ADRR) was calculated from the aldosterone concentration and DRC. The optimal cut-off point discriminating PA patients from adenoma hypertensive patients was 3.85 ng/dl/µIU/ml (AUC 0.9843; P<0.0001), achieving 94% sensitivity and specificity.
Conclusion: Determination of aldosterone and renin levels using the CLIA method and the use of the ADRR ratio show a high diagnostic value as a screening test for patients with PA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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