Measurement of Equilibrium Angiotensin II in the Diagnosis of Primary Aldosteronism

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...

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Published in:Clinical chemistry (Baltimore, Md.) Md.), 2020-03, Vol.66 (3), p.483-492
Main Authors: Guo, Zeng, Poglitsch, Marko, McWhinney, Brett C, Ungerer, Jacobus P J, Ahmed, Ashraf H, Gordon, Richard D, Wolley, Martin, Stowasser, Michael
Format: Article
Language:English
Subjects:
Aldosterone
Analysis
Angiotensin
Angiotensin II
Antihypertensives
Assaying
Biosynthesis
Consistency
Diagnosis
Diagnostic systems
Endocrine disorders
Enzymes
Equilibrium
Ethylenediaminetetraacetic acid
Fludrocortisone
Hyperaldosteronism
Hypertension
Low concentrations
Measurement
Medical diagnosis
Peptides
Physiological effects
Physiological factors
Physiology
Posture
Renin
Sensitivity
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Wolley, Martin
Stowasser, Michael
description 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. 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. EqAngII showed good consistency with DRC and PRA independent of PA diagnosis, posture, and fludrocortisone administration. EqAngII showed close (P 
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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. 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. EqAngII showed good consistency with DRC and PRA independent of PA diagnosis, posture, and fludrocortisone administration. EqAngII showed close (P &lt; 0.01) correlations with DRC (r = 0.691) and PRA (r = 0.754) during FST. DRC and PRA were below their assays' functional sensitivity in 43.9% and 15.1%, respectively, of the total 312 samples compared with only 7.4% for eqAngII (P &lt; 0.01). Bland-Altman analysis revealed an overestimation of PRA and DRC compared with eqAngII in a subset of samples with low renin levels. 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subjects Aldosterone
Analysis
Angiotensin
Angiotensin II
Antihypertensives
Assaying
Biosynthesis
Consistency
Diagnosis
Diagnostic systems
Endocrine disorders
Enzymes
Equilibrium
Ethylenediaminetetraacetic acid
Fludrocortisone
Hyperaldosteronism
Hypertension
Low concentrations
Measurement
Medical diagnosis
Peptides
Physiological effects
Physiological factors
Physiology
Posture
Renin
Sensitivity
title Measurement of Equilibrium Angiotensin II in the Diagnosis of Primary Aldosteronism
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