{"id":994258,"date":"2022-02-14T09:22:00","date_gmt":"2022-02-14T14:22:00","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=994258"},"modified":"2023-03-16T05:48:24","modified_gmt":"2023-03-16T10:48:24","slug":"aldosterone-renin-ratio","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/aldosterone-renin-ratio\/","title":{"rendered":"Aldosterone renin ratio"},"content":{"rendered":"

Interpretation of the ARR should only be made after confirming that renin is suppressed in the setting of high endogenous aldosterone production.<\/p>\n

Aldosterone renin ratio (ARR) in primary hyperaldosteronism<\/h2>\n

The absence of renin suppression<\/strong> should raise suspicion for secondary aldosteronism (not primary) <\/strong>and\/or the use of medications that raise renin<\/strong> (mineralocorticoid receptor antagonists, renin inhibitors, renin-angiotensin-aldosterone system inhibitors, ENaC inhibitors, other diuretics that induce volume contraction). A limitation of the ARR is that in the presence of very low renin levels (for example, at PRA values of 0.1 ng\/mL\/h), the ARR may be elevated even when plasma aldosterone is also low.<\/p>\n\n\n\n\n\t\n\t\n\t
Aldosterone to renin ratio<\/td>Interpretation<\/td>\n<\/tr>\n
ARR > 20<\/td>Highly suspicious for PA<\/td>\n<\/tr>\n
ARR >30<\/td>Concomitant PAC > 15 ng\/dL, has been shown to be 90% sensitive and 91% specific for the diagnosis of PA<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n

PAC Plasma aldosterone concentration, ARR Aldosterone to renin ratio<\/p>\n

Ideal testing Conditions for aldosterone renin ratio<\/h2>\n

ARR is most sensitive if samples are collected in the morning (after patients have been out of bed for at least 2 hours) and after being comfortably seated for 5 to 15 minutes<\/p>\n