1. Measurement of Equilibrium Angiotensin II in the Diagnosis of Primary Aldosteronism
- Author
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Zeng Guo, Ashraf H. Ahmed, Richard D. Gordon, Jacobus P.J. Ungerer, Martin Wolley, Marko Poglitsch, Brett McWhinney, and Michael Stowasser
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Fludrocortisone ,Clinical Biochemistry ,Radioimmunoassay ,Urology ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Plasma renin activity ,Low renin levels ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Primary aldosteronism ,Tandem Mass Spectrometry ,Hyperaldosteronism ,Renin ,Renin–angiotensin system ,medicine ,Humans ,Aldosterone ,Chromatography, High Pressure Liquid ,Volume concentration ,Aged ,Immunoassay ,business.industry ,Angiotensin II ,Biochemistry (medical) ,Middle Aged ,medicine.disease ,chemistry ,Female ,business ,medicine.drug - Abstract
Background Many medications (including most antihypertensives) and physiological factors affect the aldosterone/renin ratio (ARR) when screening for primary aldosteronism (PA). We sought to validate a novel equilibrium angiotensin II (eqAngII) assay and compare correlations between the aldosterone/angiotensin II ratio (AA2R) and the current ARR under conditions affecting the renin-angiotensin system. Methods Among 78 patients recruited, PA was excluded in 22 and confirmed in 56 by fludrocortisone suppression testing (FST). Peripheral levels of eqAngII, plasma renin activity (PRA) and direct renin concentration (DRC) were measured. Results EqAngII showed good consistency with DRC and PRA independent of PA diagnosis, posture, and fludrocortisone administration. EqAngII showed close (P Conclusions Dynamic changes of eqAngII and the AA2R show good consistency and close correlations with renin and the ARR. The eqAngII assay shows better sensitivity than DRC and PRA assays, especially at low concentrations. Whether the AA2R can reduce the impact of some factors that influence the diagnostic power of the ARR warrants further study.
- Published
- 2020