Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension

Rossi, Gian Paolo; Ceolotto, Giulio; Rossitto, Giacomo; Seccia, Teresa Maria; Maiolino, Giuseppe; Berton, Chiara; Basso, Daniela; Plebani, Mario

doi:10.1515/cclm-2015-1094

Cited by 70 publications

(43 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among the 3 major studies on recently developed enzyme assays of ARC. 7,12,13 Manolopoulou et al reported that their iSYS ARC assay was traceable to World Health Organization international standard renin (code 68/356) with its conversion factor of 1.67 (unit conversion from pg/mL to μIU/mL, meaning one unit of standard renin was measured as 600 ng using iSYS ARC assay). We used the same World Health Organization international standard of renin and determined that one unit of the renin was measured as 591 ng using Accuraseed ARC assay with conversion factor of 1.692 (unit conversion from pg/mL to μIU/mL; as shown in Methods and Results in the online-only Data Supplement).…”

Section: Discussionmentioning

confidence: 99%

“…9,10 On the contrary, measurement of plasma renin concentrations without using radioactive materials has been recently reported. 7,8,11–13 However, currently available assays for renin concentration have relatively poor sensitivities when compared with assays for plasma renin activity (PRA). It is true that the sensitivities of PRA assay have been improved by prolonging incubation time to produce more angiotensin I, making it possible to achieve sensitivity of <1.0 ng/mL per hour, 14 while producing a dilemma as to sensitivity versus rapidity.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Rapid Screening of Primary Aldosteronism by a Novel Chemiluminescent Immunoassay

et al. 2017

View full text Add to dashboard Cite

Measurement of plasma aldosterone and renin concentration, or activity, is useful for selecting antihypertensive agents and detecting hyperaldosteronism in hypertensive patients. However, it takes several days to get results when measured by radioimmunoassay and development of more rapid assays has been long expected. We have developed chemiluminescent enzyme immunoassays enabling the simultaneous measurement of both aldosterone and renin concentrations in 10 minutes by a fully automated assay using antibody-immobilized magnetic particles with quick aggregation and dispersion. We performed clinical validation of diagnostic ability of this newly developed assay-based screening of 125 patients with primary aldosteronism from 97 patients with essential hypertension. Results of this novel assay significantly correlated with the results of radioimmunoassay (aldosterone, active renin concentration, and renin activity) and liquid chromatography–tandem mass spectrometry (aldosterone). The analytic sensitivity of this particularly novel active renin assay was 0.1 pg/mL, which was better than that of radioimmunoassay (2.0 pg/mL). The ratio of aldosterone-to-renin concentrations of 6.0 (ng/dL per pg/mL) provided 92.0% sensitivity and 76.3% specificity as a cutoff for differentiating primary aldosteronism from essential hypertension. This novel measurement is expected to be a clinically reliable alternative for conventional radioimmunoassay and to provide better throughput and cost effectiveness in diagnosis of hyperaldosteronism from larger numbers of hypertensive patients in clinical settings.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Rapid Screening of Primary Aldosteronism by a Novel Chemiluminescent Immunoassay

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Measurements were performed on a LIAISON XL Analyzer. [7] Inter-assay and intra-assay coefficients of variability (CV) for renin determination are between 2.1–2.4% and 6.8–7.3%, respectively. Inter-assay CV and intra-assay CV for aldosterone determination are between 1.8–3.5% and 5.6–9.5% respectively.…”

Section: Methodsmentioning

confidence: 99%

“…[2–4] More recently an elevation in aldosterone levels was also reported in hypertensive patients with atrial fibrillation (AF). [5–7] However, whether aldosterone is elevated in normotensive patients with AF or other cardiac conditions is unknown. Furthermore, it is unclear whether alterations of the aldosterone-renin ratio (ARR) exist in unselected cardiac patients undergoing cardiac catheterization.…”

Section: Introductionmentioning

confidence: 99%

Aldosterone and renin in cardiac patients referred for catheterization

Erné¹,

Müller

Rossi

et al. 2017

Medicine

Self Cite

View full text Add to dashboard Cite

Little is known regarding alterations of the renin-angiotensin system in patients referred for cardiac catheterization. Here, we measured plasma levels of active renin and aldosterone in patients referred for cardiac catheterization in order to determine the prevalence of elevated renin, aldosterone, and the aldosterone-renin ratio.A chemiluminescence assay was used to measure plasma aldosterone concentration (PAC) and active renin levels in 833 consecutive patients, after an overnight fasting and without any medication for least 12 hours. We evaluated associations of the hormonal elevations in relation to hypertension, atrial fibrillation (AF), hypertensive cardiomyopathy, coronary artery disease (CAD), valvular disease, impaired left ventricular ejection fraction (LVEF < 35%), and pulmonary hypertension (arterial pulmonary mean pressure >25 mm Hg).Hyperaldosteronism occurred in around one-third of all examined patients, without significant differences between patients with or without the named cardiac diseases. In a comparison between patients with or without any given cardiac disease condition, renin was significantly elevated in patients with either hypertension (36.4% vs 15.9%), CAD (33.9% vs 22.1%), or impaired LVEF (47.3% vs 24.8%). The angiotensin-renin ratio was elevated in AF patients and in patients with hypertensive cardiomyopathy. Patients with AF and coexisting hypertension had elevated renin more frequently than AF patients without coexisting hypertension (35.3% vs 16.5%; P = .005). Patients with persistent/permanent AF more frequently had elevated renin than patients with paroxysmal AF (34.1% vs 15.8%; P = .007).This prospective study of consecutive cardiac disease patients referred for cardiac catheterization has revealed distinct cardiac disease condition-associated differences in the frequencies of elevations in plasma renin, PAC, and the aldosterone-renin ratio.

show abstract

“…These hormones can nowadays be measured with unprecedented accuracy in many laboratories around the world and will be even more widely available thanks to the development of accurate chemiluminescent automated simultaneous assays [12].…”

Section: Aldosterone Renin Ratio (Arr)-appmentioning

confidence: 99%

A useful tool to improve the case detection rate of primary aldosteronism

Rossi

Bisogni

2016

Journal of Hypertension

Self Cite

View full text Add to dashboard Cite

The aldosterone-renin ratio is the most popular test for the case detection of primary aldosteronism, which entails the most common, albeit overlooked, form of endocrine secondary hypertension. A major hindrance to the clinical use of the aldosterone-renin ratio depends on the difficulty of achieving the calculation of this ratio, given that laboratories provide plasma aldosterone in different units of measurement, and renin is measured as plasma renin activity or direct active renin. We have therefore developed an App, which can be downloaded from the ESH website and the Apple store, to assist practising physicians in performing this calculation. Our hope is that this simple tool will help in increasing the detection rate of primary aldosteronism and ultimately the long-term cure of many hypertensive patients.

show abstract

Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension

Cited by 70 publications

References 31 publications

Rapid Screening of Primary Aldosteronism by a Novel Chemiluminescent Immunoassay

Rapid Screening of Primary Aldosteronism by a Novel Chemiluminescent Immunoassay

Aldosterone and renin in cardiac patients referred for catheterization

A useful tool to improve the case detection rate of primary aldosteronism

Contact Info

Product

Resources

About