Document Detail


Within-patient reproducibility of the aldosterone: renin ratio in primary aldosteronism.
MedLine Citation:
PMID:  19933925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The plasma aldosterone concentration:renin ratio (ARR) is widely used for the screening of primary aldosteronism, but its reproducibility is unknown. We, therefore, investigated the within-patient reproducibility of the ARR in a prospective multicenter study of consecutive hypertensive patients referred to specialized centers for hypertension in Italy. After the patients were carefully prepared from the pharmacological standpoint, the ARR was determined at baseline in 1136 patients and repeated after, on average, 4 weeks in the patients who had initially an ARR > or =40 and in 1 of every 4 of those with an ARR <40. The reproducibility of the ARR was assessed with Passing and Bablok and Deming regression, coefficient of reproducibility, and Bland-Altman and Mountain plots. Within-patient ARR comparison was available in 268 patients, of whom 49 had an aldosterone-producing adenoma, on the basis of the "4-corner criteria." The ARR showed a highly significant within-patient correlation (r=0.69; P<0.0001) and reproducibility. Bland-Altman plot showed no proportional, magnitude-related, or absolute systematic error between the ARR; moreover, only 7% of the values, for example, slightly more than what could be expected by chance, fell out of the 95% CI for the between-test difference. The accuracy of each ARR for pinpointing aldosterone-producing adenoma patients was approximately 80%. Thus, although it was performed under different conditions in a multicenter study, the ARR showed a good within-patient reproducibility. Hence, contrary to previously claimed poor reproducibility of the ARR, these data support its use for the screening of primary aldosteronism.
Authors:
Gian Paolo Rossi; Teresa Maria Seccia; Gaetana Palumbo; Anna Belfiore; Giampaolo Bernini; Graziella Caridi; Giovambattista Desideri; Bruno Fabris; Claudio Ferri; Gilberta Giacchetti; Claudio Letizia; Mauro Maccario; Francesca Mallamaci; Massimo Mannelli; Anna Patalano; Damiano Rizzoni; Ermanno Rossi; Achille Cesare Pessina; Franco Mantero;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-11-23
Journal Detail:
Title:  Hypertension     Volume:  55     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-18     Completed Date:  2010-01-21     Revised Date:  2010-04-15    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  83-9     Citation Subset:  IM    
Affiliation:
DMCS-Internal Medicine 4, University Hospital, Via Giustiniani 2, 35126 Padova, Italy. gianpaolo.rossi@unipd.it
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MeSH Terms
Descriptor/Qualifier:
Adenoma / blood,  diagnosis
Adrenal Gland Neoplasms / blood,  diagnosis
Aldosterone / blood*
Diagnosis, Differential
Female
Humans
Hyperaldosteronism / blood*,  complications,  diagnosis*
Hypertension / complications
Male
Mass Screening
Middle Aged
Potassium / blood
Renin / blood*
Reproducibility of Results
Sensitivity and Specificity
Chemical
Reg. No./Substance:
52-39-1/Aldosterone; 7440-09-7/Potassium; EC 3.4.23.15/Renin
Investigator
Investigator/Affiliation:
Andrea Armanini / ; Giuseppe Opocher / ; Mee-Yung Mattarello / ; Vanessa Ronconi / ; Marco Boscaro / ; Reggio Emilia / ; Moretti Angelica / ; Giuseppe Andronico / ; Giovanni Cerasola / ; Enzo Porteri / ; Enrico Agabiti-Rosei / ; Carlo Costantini / ; Maria Teresa Lavazza / ; Chiara Caliumi / ; Gabriele Parenti / ; Ezio Ghigo / ; Reggio Calabria / ; Carmine Zoccali /
Comments/Corrections
Comment In:
Hypertension. 2010 May;55(5):e18; author reply e19   [PMID:  20212263 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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