Diagnostic Accuracy of Aldosterone and Renin Measurement by Chemiluminescence for Screening of Patients with Primary Aldosteronism.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101092791 Publication Model: Electronic Cited Medium: Internet ISSN: 1422-0067 (Electronic) Linking ISSN: 14220067 NLM ISO Abbreviation: Int J Mol Sci Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI, [2000-

Hyperaldosteronism*/diagnosis ; Hyperaldosteronism*/blood ; Aldosterone*/blood ; Renin*/blood ; Luminescent Measurements*/methods; Humans ; Female ; Middle Aged ; Male ; Adult ; ROC Curve ; Prospective Studies ; Hypertension/blood ; Hypertension/diagnosis ; Aged ; Reproducibility of Results

Primary aldosteronism (PA) is the most common cause of endocrine arterial hypertension, and the suggested screening test for case detection is the aldosterone-to-renin ratio (ARR) or aldosterone-to-direct renin ratio (ADRR) based on radio-immunoassay (RIA) and chemiluminescence assay (CLIA), respectively. The objective of our study was to evaluate the reliability of CLIA for aldosterone and renin measurement and the diagnostic performance of ADRR. A prospective cohort of 1110 patients referred to a single laboratory medicine center underwent measurement of aldosterone and direct renin concentration (DRC) by CLIA and measurement of aldosterone and plasma renin activity (PRA) by RIA. Of 1110 patients, 640 obtained a final diagnosis of hypertension, and 90 of these patients were diagnosed with PA. Overall, between-method correlation was highly significant for aldosterone concentrations ( R = 0.945, p < 0.001) and less strong but significant for DRC/PRA ( R = 0.422, p < 0.001). Among hypertensive patients, in PA cases, the areas under the receiver operator characteristics (ROC) curves were 0.928 (95% confidence interval 0.904-0.954) for ADRR and 0.943 (95% confidence interval 0.920-0.966) for ARR and were comparable and not significantly different. The highest accuracy was obtained with an ADRR cut-off of 25 (ng/L)/(mIU/L), displaying a sensitivity of 91% and a specificity of 85%. The chemiluminescence assay for aldosterone and DRC is a reliable method for PA diagnosis compared to the classical RIA method.

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Keywords: aldosterone; chemiluminescence; direct renin; plasma renin activity; primary aldosteronism; radio-immunoassay

4964P6T9RB (Aldosterone)
EC 3.4.23.15 (Renin)

Date Created: 20240810 Date Completed: 20240810 Latest Revision: 20240812

20240813

PMC11313086

10.3390/ijms25158453

39126022