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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/28069722/a-novel-approach-to-establishing-an-aldosterone-renin-ratio-cutoff-for-primary-aldosteronism
#1
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...
January 9, 2017: Hypertension
https://www.readbyqxmd.com/read/27994942/effect-of-telmisartan-on-kidney-function-in-patients-with-chronic-kidney-disease-an-observational-study
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/27754241/os-35-01-the-prevalence-of-sleep-apnea-syndrome-in-primary-aldosteronism
#16
Yoshikiyo Ono, Yoshitsugu Iwakura, Ryo Morimoto, Masataka Kudo, Yasuhiro Igarashi, Masahiro Nezu, Yuta Tezuka, Hiromasa Ogawa, Sadayoshi Ito, Fumitoshi Stash
OBJECTIVE: Primary aldosteronism (PA) and sleep apnea syndrome (SAS) are common form of secondary hypertension. Some papers reported the group of high risk of SAS was higher rate of complication with PA than that of low risk of SAS. However, there are few reports which evaluated CPAP implementation rate of the PA patients with SAS diagnosing by Polysomnography (PSG). We aim to clarify clinical characteristics of patients of PA with SAS. DESIGN AND METHOD: We screened with Apnomonitor 284 PA patients who underwent adrenal venous sampling (AVS)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754223/os-32-08-sympathetic-nerve-activity-and-the-low-renin-phenotype-the-sabpa-study
#17
Lebo Gafane, Alta Schutte, Johannes Van Rooyen, Rudolph Schutte
OBJECTIVE: Hypertension, particularly in black populations is often accompanied by low renin levels, indicative of possible blood pressure (BP) dysregulation by the renin-angiotensin-system (RAS). The potential role of aldosterone in sympathetic nerve activation in the context of low renin warrants clarification. We therefore explored whether measures of sympathetic nerve activity (noradrenaline, 24-hour heart rate (HR) and % dipping in night-time HR) relate to renin, aldosterone and aldosterone-to-renin ratio (ARR) in low renin blacks and whites...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754211/os-31-03-clinical-effectiveness-of-anti-hypertensive-therapy-with-acei-or-arb-assessed-by-plasma-renin-activity-plasma-aldosterone-concentration-ratio
#18
Federico Giulietti, Francesco Spannella, Elisabetta Borioni, Francesca Elena Lombardi, Laura Landi, Emma Espinosa, Riccardo Sarzani
OBJECTIVE: ACE inhibitors and angiotensin receptor blockers (ARB) modulate the renin-angiotensin system (RAS) leading to an increase in plasma renin activity (PRA) together with a reduction of plasma aldosterone concentration (PAC), likely proportional to the pharmacological effect. AIM: to evaluate the efficacy of therapy based on ACEI or ARB, using PRA/PAC ratio values in real-life clinical-practice. DESIGN AND METHOD: We studied 184 essential hypertensives (59...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754199/js-ish-eccr-4-the-plasma-aldosterone-angiotensin-ii-ratio-for-the-screening-of-secondary-hypertension
#19
Marko Poglitsch
Primary aldosteronism (PA) is severe form of hypertension characterized by a strongly increased aldosterone secretion mediated by adenomas or other forms of adrenal hyper-activity. Once detected, PA can be usually cured by either surgical intervention or by appropriate pharmacologic treatments. The incidence of PA among hypertensive patients varies strongly between different studies, which is in part caused by the complex state-of-the-art testing procedure that is unfortunately far away from being a versatile PA screening tool...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754198/js-ish-eccr-3-a-novel-algorithm-for-the-case-detection-of-the-most-common-form-of-endocrine-hypertension
#20
Gian Paolo Rossi
Primary aldosteronism (PA) involves more than 11% of patients referred to specialized hypertension centers and, therefore, is much more common than commonly held. Moreover, it causes a damage to the heart, blood vessels and kidneys, which translates into a high rate of cardiovascular events, in excess to the degree of blood pressure raise. Along with the notion that a timely diagnosis entails a fundamental step for the choice of an appropriate therapy, which can correct the arterial hypertension and the hypokalemia, this justifies efforts to search for PA in the majority of the patients with hypertension...
September 2016: Journal of Hypertension
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