The aldosterone–renin ratio: role and problems

Stowasser, Michael and Gordon, Richard Douglas (2014). The aldosterone–renin ratio: role and problems. In Per Hellman (Ed.), Primary aldosteronism: molecular genetics, endocrinology, and translational medicine (pp. 109-126) New York NY, United States: Springer New York. doi:10.1007/978-1-4939-0509-6_9


Author Stowasser, Michael
Gordon, Richard Douglas
Title of chapter The aldosterone–renin ratio: role and problems
Title of book Primary aldosteronism: molecular genetics, endocrinology, and translational medicine
Place of Publication New York NY, United States
Publisher Springer New York
Publication Year 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1007/978-1-4939-0509-6_9
Year available 2014
ISBN 9781493905089
9781493905096
Editor Per Hellman
Chapter number 9
Start page 109
End page 126
Total pages 18
Total chapters 15
Collection year 2015
Language eng
Abstract/Summary The major role of the aldosterone/renin ratio (ARR) test is in screening hypertensive patients for primary aldosteronism (PA). Although currently the most reliable and popular approach, the value of this screening test depends on an appreciation of factors (such as antihypertensive and other medications, posture, time of day, age, gender, phase of menstrual cycle, diet, presence of hypokalemia, medications, and renal function) which can affect the results, on the care with which either these factors are controlled or their effects taken into account, and on access to reliable and reproducible assays for renin and aldosterone. Even then, physiological day-to-day variability reduces the value of a single estimation, and repeated testing is advisable before deciding whether or not to proceed to further diagnostic work-up. Provided that testing of aldosterone suppressibility is always carried out in order to confirm or exclude the diagnosis, and adrenal venous sampling is employed to differentiate unilateral from bilateral forms, wide application of the ARR can have a major beneficial clinical impact, with improved therapeutic outcomes, including possible cure in those with unilateral disease and improved quality of life.
Keyword Primary aldosteronism-aldosterone
Renin
ARR
Assay methodology
Q-Index Code BX
Q-Index Status Confirmed Code
Institutional Status UQ

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Created: Mon, 20 Apr 2015, 23:04:38 EST by Caitlin Maskell on behalf of School of Medicine