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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/28186357/short-and-long-term-outcomes-with-renin-angiotensin-aldosterone-inhibitors-in-renal-transplant-recipients-a-meta-analysis-of-randomized-controlled-trials
#1
Ruo-Xi Liao, Xia-Fei Lyu, Wen-Jiao Tang, Kai Gao
BACKGROUND: Angiotensin-convertingenzyme inhibitors (ACEIs) and angiotensin II receptor type 1 blockers (ARBs) are often prescribed for renal transplant recipients (RTRs), but the outcomes of these medications in RTRs remain controversial. METHODS: The PubMed, Embase, and Cochrane Library databases were systematically searched. Randomized controlled trials investigating the outcomes of ACEI/ARBs in RTRs were included for meta-analysis. RESULTS: Twenty-two trials with 2242 patients were identified...
February 10, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28148579/liquorice-induced-apparent-mineralocorticoid-excess-presenting-in-the-emergency-department
#2
Stuart Declan Gallacher, Georgios Tsokolas, Ioannis Dimitropoulos
A 65-year-old woman with a background of myalgic encephalitis, who was taking alternative medicines and dietary supplements, presented with hypokalaemia and hypertension. After a thorough history it became apparent that this was most likely secondary to regular consumption of liquorice tea. The patient was advised to discontinue drinking this tea and was discharged. Follow-up showed normalising blood pressure and hypokalaemia, with a normal aldosterone:renin ratio.
February 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28129245/plasma-aldosterone-level-within-the-normal-range-is-less-associated-with-cardiovascular-and-cerebrovascular-risk-in-primary-aldosteronism
#3
Masahiko Murata, Tetsuhiro Kitamura, Daisuke Tamada, Kosuke Mukai, Shogo Kurebayashi, Tsunehiko Yamamoto, Kunihiko Hashimoto, Reiko D Hayashi, Haruhiko Kouhara, Sachi Takeiri, Yoshitaka Kajimoto, Makoto Nakao, Toshimitsu Hamasaki, Michio Otsuki, Iichiro Shimomura
BACKGROUND: Previous studies showed higher risk of cardiovascular and cerebrovascular (CCV) events in primary aldosteronism compared with essential hypertension, but the patients of these studies were limited to primary aldosteronism patients with high plasma aldosterone concentration (PAC). The introduction of the aldosterone-renin ratio as the screening test for primary aldosteronism led to the recognition of primary aldosteronism patients with normal PAC (nPA). However, there is no information on the risk of primary aldosteronism including nPA...
January 27, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28106020/renin-angiotensin-aldosterone-system-blockers-and-cardiovascular-outcomes-a-meta-analysis-of-randomized-clinical-trials
#4
Pınar Kızılırmak, Yağız Üresin, Oktay Özdemir, Burçak Kılıçkıran Avcı, Lale Tokgözoğlu, Zeki Öngen
OBJECTIVE: Hypertension is the most prevalent modifiable risk factor for cardiovascular (CV) and cerebrovascular morbidity and mortality. This study aimed to assess the effects of renin-angiotensin-aldosterone system (RAAS) blockade on CV outcomes. METHODS: This study was designed according to the Preferred Reporting Items for Systemic reviews and Meta-Analyses statement. Databases were searched for articles published as of December 2014. Two sets of studies were selected...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28102195/positive-association-between-kcnj5-rs2604204-a-c-polymorphism-and-plasma-aldosterone-levels-but-also-plasma-renin-and-angiotensin-i-and-ii-levels-in-newly-diagnosed-hypertensive-chinese-a-case-control-study
#5
H Wang, C Weng, H Chen
Variants in G protein-coupled inward rectifier K(+) channels 4 (GIRK4 also known as KCNJ5) gene are associated with primary aldosteronism, which is the most common cause of secondary hypertension. The KCNJ5 rs2604204 variant was shown to be common (minor allele frequency=32.5%) in Chinese patients with essential hypertension (EH). The relationship between KCNJ5 variant and plasma aldosterone (ALD) levels in EH patients has not been reported. We collected 229 patients with newly diagnosed EH without any antihypertensive agents...
January 19, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28069722/novel-approach-to-establishing-an-aldosterone-renin-ratio-cutoff-for-primary-aldosteronism
#6
Alexander A Leung, Dennis J Orton, Alex Chin, Hossein Sadrzadeh, Gregory A Kline
Direct renin concentration is replacing plasma renin activity in many laboratories for the investigation of primary aldosteronism, which may have a significant impact on the resulting aldosterone:renin ratios. We sought to develop a population-based approach to establishing an aldosterone:renin ratio cutoff when transitioning between assays. A population-based study was performed in Calgary, Alberta, Canada of 4301 individuals who received testing from January 2012 to November 2015. In 2014, direct renin concentration replaced plasma renin activity in routine testing...
March 2017: Hypertension
https://www.readbyqxmd.com/read/27994942/effect-of-telmisartan-on-kidney-function-in-patients-with-chronic-kidney-disease-an-observational-study
#7
Ashish Agrawal, Shibnath Kamila, Swetha Reddy, Joyal Lilly, Ms Sadhguna Mariyala
Background: Globally the burden of chronic kidney disease (CKD) is rising, an important cause of death and loss of disability-adjusted life years. Activation of the renin-angiotensin-aldosterone system is involved in its pathogenesis. The aim of the present study was to examine the effects of telmisartan (40 mg/day), an angiotensin receptor blocker (ARB) in Indian patients with CKD in real-life setting. Method: This was a prospective observational study. Fifty-six patients (>18 years) diagnosed with CKD were enrolled into the study...
2016: Journal of drug assessment
https://www.readbyqxmd.com/read/27965370/genetic-characterization-of-a-mouse-line-with-primary-aldosteronism
#8
Luis Gustavo Perez-Rivas, Yara Rhayem, Sibylle Sabrautzki, Constanze Hantel, Birgit Rathkolb, Martin Hrabé de Angelis, Martin Reincke, Felix Beuschlein, Ariadni Spyroglou
In an attempt to define novel genetic loci involved in the pathophysiology of primary aldosteronism a mutagenesis screen following treatment with the alkylating agent N-ethyl-N-nitrosourea was established for the parameter aldosterone. One of the generated mouse lines with hyperaldosteronism was phenotypically and genetically characterized. This mouse line had high aldosterone levels but normal creatinine and urea values. The steroidogenic enzyme expression levels in the adrenal gland did not differ significantly among phenotypically affected and unaffected mice...
December 13, 2016: Journal of Molecular Endocrinology
https://www.readbyqxmd.com/read/27932117/risk-factors-of-recurrence-of-diabetic-nephropathy-in-renal-transplants
#9
B Rodriguez Cubillo, B Rodriguez, M Calvo, V de la Manzanara, J Bautista, I Perez-Flores, N Calvo, A Moreno, A Shabaka, J Delgado, A I Sanchez-Fructuoso
BACKGROUND: Renal transplantation has been established as the treatment of choice for end-stage renal disease (ESRD) due to diabetic nephropathy. This study aimed to investigate the risk factors for recurrence of diabetic nephropathy (RDN) in renal allografts. METHODS: We studied 1,011 renal transplant patients from 1986 to 2003, of which 95 had ESRD due to diabetic nephropathy. We retrospectively analyzed the clinical characteristics and outcomes of RDN after renal transplantation...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27906842/spironolactone-and-the-risk-of-urinary-tract-cancer-in-patients-with-hypertension-a-nationwide-population-based-retrospective-case-control-study
#10
Ya-Wen Chuang, Mei-Ching Yu, Shih-Ting Huang, Cheng-Kuang Yang, Cheng-Hsu Chen, Ying-Chih Lo, Cheng-Li Lin, Kuo-Hsiung Shu, Tung-Min Yu, Chia-Hung Kao
AIM: This was a nationwide study by National Health Insurance Research Database to investigate the risk of urinary tract cancers (UTCs) for renin-angiotensin-aldosterone system inhibitors including spironolactone. METHODS: A total of 32 167 UTC patients with hypertension were enrolled in the National Health Insurance program between 2005 and 2011. RESULTS: Among different subclasses of renin-angiotensin-aldosterone system inhibitors, the adjusted odds ratio (OR) for UTC risk was 1...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27893293/prevelence-of-primary-aldosteronism-in-an-urban-hypertensive-population
#11
Sandi-Jo Galati, Khadeen C Cheesman, Ryan Springer-Miller, Sarah M Hopkins, Lawrence Krakoff, Emilia Bagiella, Rachel A Zhuk, Tiffany K Ying, Chelsey Amer, Michael K Boyajian, W B Inabnet, Alice C Levine
OBJECTIVE: To determine the prevalence of primary aldosteronism (PA) in hypertensive patients presenting to the primary care clinic at The Mount Sinai Hospital, regardless of the degree of hypertension and to identify clinical criteria that should prompt screening for PA. METHODS: An aldosterone:renin ratio (ARR, cutoff ≥20, with plasma aldosterone concentration [PAC] ≥10 and suppressed renin) was used to prospectively screen 296 hypertensive patients (blood pressure [BP] ≥140/90) over the age of 18 from August 2012 through May 2013...
November 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27885499/the-effects-of-alpha-1-adrenoceptor-blockade-and-angiotensin-converting-enzyme-inhibition-on-central-and-brachial-blood-pressure-and-vascular-reactivity-the-doxazosin-ramipril-study
#12
Andreas Jekell, Majid Kalani, Thomas Kahan
We aimed to study whether inhibition of the renin-angiotensin-aldosterone system has effects on vascular structure and function beyond the effects on blood pressure reduction alone. Patients with mild-to-moderate hypertension (n = 61, age 54 ± 12 years, 34% women) received the angiotensin converting enzyme inhibitor ramipril 10 mg or the alpha 1-adrenoceptor blocker doxazosin 8 mg double-blind for 12 weeks. Aortic blood pressure, pulse wave velocity, and augmentation index were assessed by applanation tonometry...
November 24, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27867524/varying-effects-of-recommended-treatments-for-heart-failure-with-reduced-ejection-fraction-meta-analysis-of-randomized-controlled-trials-in-the-esc-and-accf-aha-guidelines
#13
REVIEW
Marius Mark Thomsen, Christian Lewinter, Lars Køber
The aim of this paper is to evaluate the treatment effects of recommended drugs and devices on key clinical outcomes for patients with heart failure with reduced ejection fraction (HFREF). Randomized controlled trials (RCTs) listed in the 2012 HF guideline from the European Society of Cardiology as well as the 2013 HF guideline from the American College of Cardiology Foundation and American Heart Association were evaluated for use in the meta-analysis. RCTs written in English evaluating recommended drugs and devices for the treatment of patients with HFREF were included...
December 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27862131/scoring-system-for-the-diagnosis-of-bilateral-primary-aldosteronism-in-the-outpatient-setting-before-adrenal-venous-sampling
#14
Hiroki Kobayashi, Akira Haketa, Takahiro Ueno, Yukihiro Ikeda, Yoshinari Hatanaka, Sho Tanaka, Hiromasa Otsuka, Masanori Abe, Noboru Fukuda, Masayoshi Soma
OBJECTIVE: The only reliable method for subtyping primary aldosteronism (PA) is adrenal venous sampling (AVS), which is costly and time-consuming. Considering the limited availability of AVS, it would be helpful to obtain information on the diagnosis of bilateral hyperaldosteronism (BHA) from routine tests. We aimed to establish new, simple criteria for outpatients to diagnose BHA from PA before AVS. DESIGN: We retrospectively analysed 82 patients who were diagnosed with PA and underwent AVS...
November 8, 2016: Clinical Endocrinology
https://www.readbyqxmd.com/read/27834080/cardiac-dysfunction-in-association-with-increased-inflammatory-markers-in-primary-aldosteronism
#15
Jung Soo Lim, Sungha Park, Sung Il Park, Young Taik Oh, Eunhee Choi, Jang Young Kim, Yumie Rhee
BACKGROUND: Oxidative stress in primary aldosteronism (PA) is thought to worsen aldosterone-induced damage by activating proinflammatory processes. Therefore, we investigated whether inflammatory markers associated with oxidative stress is increased with negative impacts on heart function as evaluated by echocardiography in patients with PA. METHODS: Thirty-two subjects (mean age, 50.3±11.0 years; 14 males, 18 females) whose aldosterone-renin ratio was more than 30 among patients who visited Severance Hospital since 2010 were enrolled...
December 2016: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27826732/renin-angiotensin-ii-aldosterone-system-blockers-and-time-to-renal-replacement-therapy-in-children-with-ckd
#16
Alison G Abraham, Aisha Betoko, Jeffrey J Fadrowski, Christopher Pierce, Susan L Furth, Bradley A Warady, Alvaro Muñoz
BACKGROUND: Clinical care decisions to treat chronic kidney disease (CKD) in a growing child must often be made without the benefit of evidence from clinical trials. We used observational data from the Chronic Kidney Disease in Children cohort to estimate the effectiveness of renin-angiotensin II-aldosterone system blockade (RAAS) to delay renal replacement therapy (RRT) in children with CKD. METHODS: A total of 851 participants (median age: 11 years, median glomerular filtration rate [GFR]: 52 ml/min/1...
November 8, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27797672/low-dheas-a-sensitive-and-specific-test-for-detection-of-subclinical-hypercortisolism-in-adrenal-incidentalomas
#17
Michael Conall Dennedy, Anand K Annamalai, Olivia Prankerd Smith, Natalie Freeman, Kuhan Vengopal, Johann Graggaber, Olympia Koulouri, Andrew S Powlson, Ashley Shaw, David J Halsall, Mark Gurnell
CONTEXT: Subclinical hypercortisolism (SH) occurs in 5-30% of adrenal incidentalomas (AIs). Common screening tests for adrenocorticotropin (ACTH)-independent hypercortisolism have significant false positive rates, mandating further time and resource intensive investigations. OBJECTIVE: To determine whether low basal dehydroepiandrosterone sulphate (DHEAS) is a sensitive and specific screening test for SH in AI. SETTING AND PATIENTS: 185 patients with AI were screened for adrenal medullary (plasma metanephrines) and cortical [1 mg overnight dexamethasone suppression test (ONDST), 24h urinary free cortisol (UFC), serum DHEAS, plasma renin and aldosterone] hyperfunction...
October 31, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27776721/primary-aldosteronism-diagnosis-and-management
#18
REVIEW
Geeta Gyamlani, Carol M Headley, Adnan Naseer, Ganpat S Valaulikar, Stephen A Geraci
Primary aldosteronism (PA) is an important and commonly unrecognized cause of secondary hypertension. Idiopathic hyperaldosteronism and aldosterone-producing adenomas account for more than 95% of PA and are characterized, respectively, by bilateral or unilateral involvement of the adrenal glands. When there is suspicion for the presence of PA, a plasma aldosterone to renin ratio should be obtained initially. Localization to determine adrenal gland involvement is done by imaging, with computerized tomography or magnetic resonance imaging...
October 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27754245/os-35-05-measurement-of-angiotensin-ii-at-equilibrium-in-the-diagnostic-workup-of-primary-aldosteronism-impact-of-patient-positioning-and-ace-inhibitor-treatment
#19
Marko Poglitsch, Ashraf H Ahmed, Andrea Stoller, Dunja Van Oyen, Cornelia Schwager, Claudia Aigner, Oliver Domenig, Manuel Haschke, Michael Stowasser
OBJECTIVE: Primary aldosteronism (PA) is a widely under-diagnosed, potentially curable and specifically treatable cause of hypertension. PA screening involves measuring the aldosterone-to-renin-ratio (ARR), but false negative results can occur in the setting of medications, which block the renin-angiotensin system (RAS). Withdrawing RAS blockers from patients with resistant hypertension is not without cardiovascular risk. A novel diagnostic approach, the aldosterone-to-angiotensin-II-ratio (AA2-Ratio), has the potential for less drug interference and improved reliability in PA screening and confirmation of diagnosis...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754244/os-35-04-the-aa2-ratio-towards-improved-screening-for-primary-aldosteronism-in-hypertension
#20
Marko Poglitsch, Ashraf H Ahmed, Michael Resl, Andrea Stoller, Dunja Van Oyen, Cornelia Schwager, Claudia Aigner, Oliver Domenig, Michael Krebs, Manuel Haschke, Michael Stowasser
OBJECTIVE: Primary aldosteronism (PA) is form of hypertension characterized by production of aldosterone by the adrenal that is excessive and relatively autonomous of the renin-angiotensin system. Once detected, unilateral PA can be usually cured by surgical removal of the affected adrenal, while bilateral PA can be specifically treated by medications, which antagonize aldosterone action. Clinical guidelines of Endocrine Societies in Europe and the US recommend screening for PA among most hypertensive patients...
September 2016: Journal of Hypertension
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