6.8 Application of a New Chemiluminescent Method for Direct Renin Measurement to the Calculation of Aldosterone/Renin Ra
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High Blood Press Cardiovasc Prev 2008; 15 (3): 171-215 1120-9879/08/0003-0171/$48.00/0 © 2008 Adis Data Information BV. All rights reserved.
Hormonal Mechanisms 6.8 Application of a New Chemiluminescent Method for Direct Renin Measurement to the Calculation of Aldosterone/Renin Ratio in Patients with Essential Hypertension C. Lonati (1), A. Gritti (1), B. Gidaro (1), A. Morganti (1) ` degli Studi (1)Ospedale San Giuseppe -Centro Ipertensione Arteriosa, Universita di Milano, Milano, Italy Introduction. Aldosterone/renin ratio (ARR) is increasingly used for the diagnosis of primary hyperaldosteronism with aldosterone (A) values expressed in ng/dl and renin (R) measured as plasma renin activity (PRA, ng/ml/h) with an enzymatic technique. However, a new chemiluminescent immunoassay (CLIA) has recently been developed as an alternative to the enzymatic method for the direct quantification of R expressed in mU/dl. Methods. In 45 patients with essential hypertension, 17 off treatment with ACE inhibitors or angiotensin receptor antagonists (no-ACEIs/ARBs) and 28 on chronic treatment with ACEIs or ARBs, we compared ARR with R measured as PRA or as direct immunoreactive R (ARRE and ARRD) in plasma samples collected both in the supine position (S) and after 1 hour of active standing (AS). Results. In the 17 no-ACEIs/ARBs patients, ARRE in S was 15 + 3 (range 1-63) and increased to 28 + 8 (3-141) after AS, the corresponding values of ARRD being 5.1 + 1.4 (0.5-24.2) and 9.4 + 2.6 (1.141.5). In the 28 patients on treatment with ACEIs/ARBs ARRE was 16 + 5 (1-140) in S and 23 + 8 (0-181) after AS, the corresponding values of ARRD being 5.2 + 1.5(0.3-34.1) and 7.9 + 2.9 (0.2-69.6). Both in S and after AS ARRE and ARRD values were significantly correlated (respectively r = 0.89 and 0.89 for no-ACEIs/ARBs patients, 0.91 and 0.96 for patients on treatment with ACEIs or ARBs, p
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