A screening procedure for primary aldosteronism based on the Diasorin Liaison® automated chemiluminescent immunoassay for direct renin

Dorrian, C. A., Toole, B. J., Alvarez-Madrazo, S., Kelly, A., Connell, J. M. C. and Wallace, A. M. (2010) A screening procedure for primary aldosteronism based on the Diasorin Liaison® automated chemiluminescent immunoassay for direct renin. Annals of Clinical Biochemistry, 47(3), pp. 195-199. (doi:10.1258/acb.2010.009230)

Dorrian, C. A., Toole, B. J., Alvarez-Madrazo, S., Kelly, A., Connell, J. M. C. and Wallace, A. M. (2010) A screening procedure for primary aldosteronism based on the Diasorin Liaison® automated chemiluminescent immunoassay for direct renin. Annals of Clinical Biochemistry, 47(3), pp. 195-199. (doi:10.1258/acb.2010.009230)

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Publisher's URL: http://dx.doi.org/10.1258/acb.2010.009230

Abstract

<b>Background</b> Primary aldosteronism (PA), the most common secondary cause of hypertension, can be screened for using the aldosterone/renin ratio. This ratio is raised in PA and its accuracy depends on the ability to measure plasma renin at extremely low concentrations.<p></p> <b>Methods</b> We compared two different procedures for assessing plasma renin. The conventional method, which measures plasma renin activity (PRA), is technically demanding and laborious, and the Diasorin Liaison<sup>®</sup> method, which measures plasma renin concentration (PRC), is an automated immunoassay. Results from each method were used to calculate the aldosterone/renin ratio (ARR) and the performance of the Diasorin Liaison<sup>®</sup> method compared with that of the conventional assay using receiver operator characteristic curves.<p></p> <b>Results</b> The analytical and functional sensitivity of the PRC method were 2.1 and 5 μIU/mL, respectively. Intra- and inter-assay precision were <7.2% and 10.4%, respectively. There was significant (9%) prorenin interference. Samples with PRA > 1.0 ng/mL/h showed significant correlation with PRC (r = 0.93; P < 0.05; n = 146); however, with PRA < 1.0 ng/mL/h, no significant correlation occurred (r = 0.14; P < 0.05; n = 79). An aldosterone (pmol/L)/PRC(μIU/mL) ratio of >35, in patients with aldosterone >300 pmol/L, resulted in 100% sensitivity and 93% specificity, when compared with the commonly accepted aldosterone (pmol/L)/PRA (ng/mL/h) ratio of >750, in identifying patients who may suffer from PA.<p></p> <b>Conclusion</b> This study indicates the feasibility of using the automated PRC assay as a replacement for the conventional manual PRA assay in calculating the ARR as a first-line screen for PA.<p></p>

Item Type:Articles
Keywords:ALDOSTERONE ASSAY ENGLAND hypertension Immunoassay PATIENT patients PERFORMANCE PLASMA PLASMA-ALDOSTERONE PRIMARY ALDOSTERONISM PRORENIN RATIO Scotland SCREEN TECHNOLOGIES technology
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Connell, Professor John and Alvarez-Madrazo, Dr Samantha
Authors: Dorrian, C. A., Toole, B. J., Alvarez-Madrazo, S., Kelly, A., Connell, J. M. C., and Wallace, A. M.
College/School:College of Medical Veterinary and Life Sciences
Journal Name:Annals of Clinical Biochemistry
Publisher:Sage
ISSN:0004-5632
ISSN (Online):1758-1001
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
392521Regulation of aldosterone and cortisol synthesis in hypertension and cardiovascular diseaseEleanor DaviesMedical Research Council (MRC)G0400874Institute of Cardiovascular and Medical Sciences
392522Regulation of aldosterone and cortisol synthesis in hypertension and cardiovascular diseaseEleanor DaviesMedical Research Council (MRC)G0400874Institute of Cardiovascular and Medical Sciences