Journal of Diagnostics Concepts & Practice >
Diagnostic value of measuring the plasma renin and aldosterone by chemiluminescence immunoassay in the primary aldosteronism
Received date: 2020-07-20
Online published: 2022-07-14
Objectives: To verify the accuracy of measuring the plasma renin and aldosterone by chemiluminescence immunoassay (CLIA) and assess its diagnostic efficacy in primary aldosteronism (PA). Methods: The plasma renin and aldosterone level were detected in out-and in-patients using CLIA, enzyme-linked immunosorbent assay(ELISA) and radioimmunoassay, and the intravenous saline infusion test was conducted as confirmatory test. The consistence among three tests was assessed with Pearson correlation analysis and Bland-Altman analysis. The aldosterone and renin level detected by CLIA were used to calculate aldosterone to renin ratio (ARR). The receiver operator characteristic curve (ROC curve) was performed to determine the optimized ARR cut-off value and the area under ROC curve (AUC) for diagnosing PA. Results: The aldosterone and renin concentration detected by CLIA were significantly correlated with the results tested by ELISA(rennin and aldosterone concentration) and radioimmunoassay (renin activity and aldosterone concentration) respectively(r≥0.67, P<0.01; r≥0.79, P<0.01). Compared with that by CLIA using blood collection tube with the enzyme inhibitor, rennin concentration by CLIA using blood collection tube without enzyme inhibitor had a better correlation with renin activity by radioimmunoassay (correlation coefficient: 0.80 vs. 0.67, P<0.01). In 45 hypertension patients, the AUC of ARR acquired by CLIA for diagnosing PA was 0.91 and the optimized ARR cut-off value was 18.26 [(pg/mL)/(pg/mL)], and both sensitivity and specificity were 86.7%. Conclusions: CLIA could be used for clinical PA screening as a reliable detective method since it has high accuracy of measuring plasma renin and aldosterone.
CHENG Yibang, LI Mingxuan, CHEN Bo, CAO Sheng, JIANG Gonghao, XU Jianzhong, LI Yan, WANG Jiguang . Diagnostic value of measuring the plasma renin and aldosterone by chemiluminescence immunoassay in the primary aldosteronism[J]. Journal of Diagnostics Concepts & Practice, 2020 , 19(05) : 474 -480 . DOI: 10.16150/j.1671-2870.2020.05.006
[1] | Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J]. Hypertension, 2018, 71(6):e13-e115. |
[2] | Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline[J]. J Clin Endocrinol Metab, 2016, 101(5):1889-1916. |
[3] | Wang D, Xu JZ, Chen X, et al. Left atrial myocardial dysfunction in patients with primary aldosteronism as assessed by speckle-tracking echocardiography[J]. J Hypertens, 2019, 37(10):2032-2040. |
[4] | Milliez P, Girerd X, Plouin PF, et al. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism[J]. J Am Coll Cardiol, 2005, 45(8):1243-1248. |
[5] | Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate[J]. Ann Intern Med, 2009, 150(9):604-612. |
[6] | Perschel FH, Schemer R, Seiler L, et al. Rapid screening test for primary hyperaldosteronism: ratio of plasma aldosterone to renin concentration determined by fully automated chemiluminescence immunoassays[J]. Clin Chem, 2004, 50(9):1650-1655. |
[7] | Manolopoulou J, Fischer E, Dietz A, et al. Clinical validation for the aldosterone-to-renin ratio and aldosterone suppression testing using simultaneous fully automated chemiluminescence immunoassays[J]. J Hypertens, 2015, 33(12):2500-2511. |
[8] | Morimoto R, Ono Y, Tezuka Y, et al. Rapid screening of primary aldosteronism by a novel chemiluminescent immunoassay[J]. Hypertension, 2017, 70(2):334-341. |
[9] | Rossi GP, Ceolotto G, Rossitto G, et al. Prospective validation of an automated chemiluminescence-based assay of renin and aldosterone for the work-up of arterial hypertension[J]. Clin Chem Lab Med, 2016, 54(9):1441-1450. |
[10] | Funder JW, Carey RM, Fardella C, et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline[J]. J Clin Endocrinol Metab, 2008, 93(9):3266-3281. |
[11] | 陈绍行, 杜月凌, 张瑾, 等. 在高血压患者中筛选原发性醛固酮增多症国人血浆醛固酮/肾素活性比值标准的探讨[J]. 中华心血管病杂志, 2006, 34(10):868-872. |
/
〈 |
|
〉 |