Within-patient reproducibility of the aldosterone: renin ratio in primary aldosteronism.

Giovanni Cerasola, Giuseppe Andronico, Anna Patalano, Francesca Mallamaci, Anna Belfiore, Achille Cesare Pessina, Franco Mantero, Anna Belfiore, Giovambattista Desideri, Anna Belfiore, Teresa Maria Seccia, Gilberta Giacchetti, Graziella Caridi, Bruno Fabris, Giampaolo Bernini, Massimo Mannelli, Mauro Maccario, Damiano Rizzoni, Claudio Letizia, Claudio FerriGaetana Palumbo, Ermanno Rossi, Gian Paolo Rossi

    Risultato della ricerca: Articlepeer review

    58 Citazioni (Scopus)

    Abstract

    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.
    Lingua originaleEnglish
    pagine (da-a)83-89
    Numero di pagine7
    RivistaHypertension
    Volume55
    Stato di pubblicazionePublished - 2010

    All Science Journal Classification (ASJC) codes

    • ???subjectarea.asjc.2700.2724???

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