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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/28716801/diabetes-mellitus-microalbuminuria-and-subclinical-cardiac-disease-identification-and-monitoring-of-individuals-at-risk-of-heart-failure
#1
Peter P Swoboda, Adam K McDiarmid, Bara Erhayiem, David P Ripley, Laura E Dobson, Pankaj Garg, Tarique A Musa, Klaus K Witte, Mark T Kearney, Julian H Barth, Ramzi Ajjan, John P Greenwood, Sven Plein
BACKGROUND: Patients with type 2 diabetes mellitus and elevated urinary albumin:creatinine ratio (ACR) have increased risk of heart failure. We hypothesized this was because of cardiac tissue changes rather than silent coronary artery disease. METHODS AND RESULTS: In a case-controlled observational study 130 subjects including 50 ACR+ve diabetes mellitus patients with persistent microalbuminuria (ACR >2.5 mg/mol in males and >3.5 mg/mol in females, ≥2 measurements, no previous renin-angiotensin-aldosterone therapy, 50 ACR-ve diabetes mellitus patients and 30 controls underwent cardiovascular magnetic resonance for investigation of myocardial fibrosis, ischemia and infarction, and echocardiography...
July 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28711910/combined-renin-angiotensin-aldosterone-system-blockade-and-statin-therapy-effectively-reduces-the-risk-of-cerebrovascular-accident-in-autosomal-dominant-polycystic-kidney-disease-a-nationwide-population-based-cohort-study
#2
Pei-Hsun Sung, Hsin-Ju Chiang, Mel S Lee, John Y Chiang, Hon-Kan Yip, Yao-Hsu Yang
Fairly limited data reported the incidence and risk of cerebrovascular accident (CVA) in autosomal dominant polycystic kidney disease (ADPKD). Additionally, little is known regarding the therapeutic impact of renin-angiotensin-aldosterone system (RAAS) blockade and statin on reducing the occurrence of CVA in ADPKD. We utilized the data from Taiwan National Health Insurance Research Database (NHIRD) to perform a population-based cohort study (1997-2013). A total of 2,647 patients with ADPKD were selected from 1,000,000 general population after excluding patients with age<18, renal replacement therapy and concomitant diagnosis of CVA...
June 27, 2017: Oncotarget
https://www.readbyqxmd.com/read/28699986/diagnosis-and-management-of-primary-aldosteronism
#3
Leticia A P Vilela, Madson Q Almeida
Primary aldosteronism (PA) is the most common form of secondary hypertension (HTN), with an estimated prevalence of 4% of hypertensive patients in primary care and around 10% of referred patients. Patients with PA have higher cardiovascular morbidity and mortality than age- and sex-matched patients with essential HTN and the same degree of blood pressure elevation. PA is characterized by an autonomous aldosterone production causing sodium retention, plasma renin supression, HTN, cardiovascular damage, and increased potassium excretion, leading to variable degrees of hypokalemia...
May 2017: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28672763/a-step-by-step-approach-in-differential-diagnosing-of-adrenal-incidentaloma-epinephroma-with-comments-on-the-new-clinical-practice-guidelines-of-the-european-society-of-endocrinology
#4
Frederick-Anthony Farrugia, Evangelos Misiakos, Georgios Martikos, Panagiotis Tzanetis, Anestis Charalampopoulos, Nicolaos Zavras, Dimitrios Sotiropoulos, Nikolaos Koliakos
OBJECTIVES: To present a step by step approach for the diagnosis of adrenal incidentaloma (AI). METHOD: An extensive review of the literature was conducted, searching the Pub-Med and Google Scholar using the Mesh terms; Adrenal; Incidentaloma; Adrenal tumours; Radiology; Diagnosis. We also did a cross-referencing search of the literature. Comments on the new European guidelines are presented. RESULTS: The majority of the tumours are non-functioning benign adenomas...
June 23, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28664839/effects-of-paricalcitol-on-biomarkers-of-inflammation-and-fibrosis-in-kidney-transplant-recipients-results-of-a-randomized-controlled-trial
#5
Manca Oblak, Gregor Mlinšek, Aljoša Kandus, Jadranka Buturović-Ponikvar, Miha Arnol
AIMS: Paricalcitol, a selective vitamin D activator, decreases proteinuria and may reduce graft failure risk in kidney transplant recipients. In this study, we evaluated the effect of paricalcitol on renin-angiotensin system (RAS) activity as well as interleukin (IL)-6 and transforming growth factor (TGF)-β plasma concentrations as biomarkers of inflammation and fibrosis. METHODS: This placebo-controlled, double-blind trial enrolled a national cohort of kidney transplant recipients with urinary protein-to-creatinine ratio (UPCR) ≥ 20 mg/mmol despite optimization of the RAS blockade...
June 30, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28652474/rapid-screening-of-primary-aldosteronism-by-a-novel-chemiluminescent-immunoassay
#6
Ryo Morimoto, Yoshikiyo Ono, Yuta Tezuka, Masataka Kudo, Sachiko Yamamoto, Toshiaki Arai, Celso E Gomez-Sanchez, Hironobu Sasano, Sadayoshi Ito, Fumitoshi Satoh
Measurement of plasma aldosterone and renin concentration, or activity, is useful for selecting antihypertensive agents and detecting hyperaldosteronism in hypertensive patients. However, it takes several days to get results when measured by radioimmunoassay and development of more rapid assays has been long expected. We have developed chemiluminescent enzyme immunoassays enabling the simultaneous measurement of both aldosterone and renin concentrations in 10 minutes by a fully automated assay using antibody-immobilized magnetic particles with quick aggregation and dispersion...
June 26, 2017: Hypertension
https://www.readbyqxmd.com/read/28640140/aldosterone-and-renin-in-cardiac-patients-referred-for-catheterization
#7
Paul Erne, Andrea Müller, Gian Paolo Rossi, Burkhardt Seifert, Fabrice Stehlin, Maurice Redondo, Peter T Bauer, Richard Kobza, Therese J Resink, Dragana Radovanovic
Little is known regarding alterations of the renin-angiotensin system in patients referred for cardiac catheterization. Here, we measured plasma levels of active renin and aldosterone in patients referred for cardiac catheterization in order to determine the prevalence of elevated renin, aldosterone, and the aldosterone-renin ratio.A chemiluminescence assay was used to measure plasma aldosterone concentration (PAC) and active renin levels in 833 consecutive patients, after an overnight fasting and without any medication for least 12 hours...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28614094/plasma-renin-activity-to-plasma-aldosterone-concentration-ratio-correlates-with-night-time-and-pulse-pressures-in-essential-hypertensive-patients-treated-with-angiotensin-converting-enzyme-inhibitors-at1-blockers
#8
Francesco Spannella, Federico Giulietti, Paolo Balietti, Elisabetta Borioni, Francesca E Lombardi, Maddalena Ricci, Guido Cocci, Laura Landi, Riccardo Sarzani
OBJECTIVES: Angiotensin-converting enzyme inhibitors (ACE-I) and AT1 blockers (ARB) are commonly used antihypertensive drugs, but several factors may affect their effectiveness. We evaluated the associations between ambulatory blood pressure (BP) monitoring (ABPM) parameters and plasma renin activity (PRA)-to-plasma aldosterone concentration (PAC) ratio (RAR) to test renin-angiotensin-aldosterone system inhibition in essential hypertensive patients treated with ACE-I or ARB for at least 12 months...
June 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28612447/obesity-and-the-diagnostic-accuracy-for-primary-aldosteronism
#9
Amit Tirosh, Fady Hannah-Shmouni, Charalampos Lyssikatos, Elena Belyavskaya, Mihail Zilbermint, Smita B Abraham, Maya B Lodish, Constantine A Stratakis
The effects of body mass index on the diagnostic accuracy of primary aldosteronism (PA) are inconsistent and yet important considering the high prevalence and frequent co-occurrence of obesity and hypertension. The current study included 59 adult patients who underwent a stepwise evaluation for PA, using aldosterone to renin ratio for case detection and plasma aldosterone concentration after saline suppression test and/or 24-hour urinary aldosterone after oral sodium loading for case confirmation. Body mass index had a quadratic (U-shaped) correlation with plasma aldosterone concentration, plasma renin activity, aldosterone to renin ratio, and plasma aldosterone concentration after saline suppression test...
June 13, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28592038/-the-application-of-captopril-challenge-test-in-the-diagnosis-of-primary-aldosteronism
#10
S Chen, Z P Zeng, A L Song, L Zhu, L Lu, A L Tong, C Shi, H Z Li
Objective: To evaluate the value of captopril challenge test (CCT) in the diagnosis of primary aldosteronism (PA). Methods: A total of 674 patients [(45.0±13.7) years, men 341, women 333] admitted to Peking Union Medical College Hospital from 2000 to 2015 were analyzed. Among them, 222 subjects were with essential hypertension (EH), 28 were with pheochromocytoma (PHEO), 246 were with idiopathic hyperaldosteronism (IHA) and 178 were with aldosterone producing adenoma (APA). All patients received CCT. 24 h urine sodium was measured in partial patients...
June 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28576855/sodium-balance-circadian-bp-rhythm-heart-rate-variability-and-intrarenal-renin-angiotensin-aldosterone-and-dopaminergic-systems-in-acute-phase-of-arb-therapy
#11
Yukako Isobe-Sasaki, Michio Fukuda, Yoshiaki Ogiyama, Ryo Sato, Toshiyuki Miura, Daisuke Fuwa, Masashi Mizuno, Tetsuhei Matsuoka, Hiroko Shibata, Hiroyuki Ito, Minamo Ono, Sumiko Abe-Dohmae, Ken Kiyono, Yoshiharu Yamamoto, Hiroyuki Kobori, Makoto Michikawa, Junichiro Hayano, Nobuyuki Ohte
We have revealed that even in humans, activated intrarenal renin-angiotensin-aldosterone system (RAAS) enhances tubular sodium reabsorption to facilitate salt sensitivity and nondipper rhythm of blood pressure (BP), and that angiotensin receptor blocker (ARB) could increase daytime urinary sodium excretion rate (UNaV) to produce lower sodium balance and restore nondipper rhythm. However, the sympathetic nervous system and intrarenal dopaminergic system can also contribute to renal sodium handling. A total of 20 patients with chronic kidney disease (61 ± 15 years) underwent 24-h ambulatory BP monitoring before and during two-day treatment with ARB, azilsartan...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28576687/outcomes-after-adrenalectomy-for-unilateral-primary-aldosteronism-an-international-consensus-on-outcome-measures-and-analysis-of-remission-rates-in-an-international-cohort
#12
Tracy A Williams, Jacques W M Lenders, Paolo Mulatero, Jacopo Burrello, Marietta Rottenkolber, Christian Adolf, Fumitoshi Satoh, Laurence Amar, Marcus Quinkler, Jaap Deinum, Felix Beuschlein, Kanako K Kitamoto, Uyen Pham, Ryo Morimoto, Hironobu Umakoshi, Aleksander Prejbisz, Tomaz Kocjan, Mitsuhide Naruse, Michael Stowasser, Tetsuo Nishikawa, William F Young, Celso E Gomez-Sanchez, John W Funder, Martin Reincke
BACKGROUND: Although unilateral primary aldosteronism is the most common surgically correctable cause of hypertension, no standard criteria exist to classify surgical outcomes. We aimed to create consensus criteria for clinical and biochemical outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism and apply these criteria to an international cohort to analyse the frequency of remission and identify preoperative determinants of successful outcome. METHODS: The Primary Aldosteronism Surgical Outcome (PASO) study was an international project to develop consensus criteria for outcomes and follow-up of adrenalectomy for unilateral primary aldosteronism...
May 30, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28576479/aldosterone-breakthrough-in-dogs-with-naturally-occurring-myxomatous-mitral-valve-disease
#13
M K Ames, C E Atkins, A Eriksson, A M Hess
INTRODUCTION: Aldosterone breakthrough (ABT) is the condition in which angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin receptor blockers fail to effectively suppress the activity of the renin angiotensin aldosterone system. The objective of this study was to determine if ABT occurs in dogs with naturally occurring myxomatous mitral valve disease receiving an ACEI, using the urine aldosterone to creatinine ratio (UAldo:C) as a measure of renin angiotensin aldosterone system activation...
June 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28567353/differential-efficacy-profile-of-aldosterone-receptor-antagonists-depending-on-the-type-of-chronic-heart-failure-whether-with-reduced-or-preserved-left-ventricular-ejection-fraction-results-of-a-meta-analysis-of-randomized-controlled-trials
#14
Renato De Vecchis, Carmelina Ariano
BACKGROUND: Because of renin-angiotensin-aldosterone system (RAAS) activation, the patients with chronic heart failure (CHF) manifest increased ventricular stress, with impaired left ventricular function, and a slowing down in systemic venous drainage. More importantly, a reduction of the patient's life expectancy has been proven in the case of RAAS overstimulation. For these reasons, huge efforts have been made to obtain molecules able to efficaciously antagonize the RAAS overstimulation, such as aldosterone receptor antagonists (ARAs)...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28566337/age-related-autonomous-aldosteronism
#15
Kazutaka Nanba, Anand Vaidya, Gordon H Williams, Isabel Zheng, Tobias Else, William E Rainey
Background -Both aging and inappropriate secretion of aldosterone increase the risk for developing cardiovascular disease; however, the influence of aging on aldosterone secretion and physiology is not well understood. Methods -The relationship between age and adrenal aldosterone synthase (CYP11B2) expression was evaluated in 127 normal adrenals from deceased kidney donors (age 9mo-68y). Following immunohistochemistry, CYP11B2 expressing area and areas of abnormal foci of CYP11B2 expressing cells, called aldosterone-producing cell clusters (APCCs), were analyzed...
May 31, 2017: Circulation
https://www.readbyqxmd.com/read/28545792/living-alone-and-activation-of-the-renin-angiotensin-aldosterone-system-differential-effects-depending-on-alexithymic-personality-features
#16
Jan Terock, Anke Hannemann, Deborah Janowitz, Henry Völzke, Matthias Nauck, Harald-Jürgen Freyberger, Henri Wallaschofski, Hans Jörgen Grabe
OBJECTIVE: Living alone is considered as a chronic stress factor predicting different health conditions and particularly cardiovascular disease (CVD). Alexithymia is associated with increased psychological distress, less social skills and fewer close relationships, making alexithymic subjects particularly susceptible to chronic stress imposed by "living alone". Only few studies investigated the renin-angiotensin-aldosterone-system (RAAS) activity in response to chronic stress. We aimed at evaluating the effects of "living alone" as a paradigm for chronic stress on RAAS activity and putatively differential effects depending on alexithymic personality features...
May 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28540931/hyperkalemia-in-both-surgically-and-medically-treated-patients-with-primary-aldosteronism
#17
N Wada, Y Shibayama, H Umakoshi, T Ichijo, Y Fujii, K Kamemura, T Kai, R Sakamoto, A Ogo, Y Matsuda, T Fukuoka, M Tsuiki, T Suzuki, M Naruse
Hyperkalemia is an important complication of adrenalectomy for patients with primary aldosteronism (PA). The frequency of hyperkalemia after medication using mineralocorticoid receptor antagonists (MRAs) for PA is unclear. The aim of this study is to investigate the frequency and the risk factors of hyperkalemia after surgery and medication for PA. The data of 376 patients with PA registered in a multicentre-collaborative study in Japan, including surgically treated patients (group A; n=142) and medically treated patients with MRAs (group B; n=234) were studied...
May 25, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/28529209/quantitative-value-of-aldosterone-renin-ratio-for-detection-of-aldosterone-producing-adenoma-the-aldosterone-renin-ratio-for-primary-aldosteronism-aquarr-study
#18
Giuseppe Maiolino, Giacomo Rossitto, Valeria Bisogni, Maurizio Cesari, Teresa Maria Seccia, Mario Plebani, Gian Paolo Rossi
BACKGROUND: Current guidelines recommend use of the aldosterone-renin ratio (ARR) for the case detection of primary aldosteronism followed by confirmatory tests to exclude false-positive results from further diagnostic workup. We investigated the hypothesis that this could be unnecessary in patients with a high ARR value if the quantitative information carried by the ARR is taken into due consideration. METHODS AND RESULTS: We interrogated 2 large data sets of prospectively collected patients studied with the same predefined protocol, which included the captopril challenge test...
May 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28513286/azelnidipine-is-a-useful-medication-for-the-treatment-of-heart-failure-preserved-ejection-fraction
#19
Shunsuke Kiuchi, Shinji Hisatake, Takayuki Kabuki, Takashi Oka, Shintaro Dobashi, Takahiro Fujii, Takanori Ikeda
BACKGROUND: The optimal therapy in patients with heart failure preserved ejection fraction (HFpEF) and hypertension (HT) has not been revealed. The beta blocker (BB) and the renin angiotensin aldosterone system inhibitor (RAAS-I) are recommend as class IIa in patients with HFpEF. The calcium channel blocker (CCB), a major anti-hypertensive drugs in Japan, is also recommend as class IIa in patients with HFpEF. However, the difference between azelnidipine, an L type CCB, and cilnidipine, an N type CCB, is unclear...
2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28493291/prevalence-of-primary-aldosteronism-among-patients-with-type-2-diabetes
#20
Mauro Tancredi, Gudmundur Johannsson, Björn Eliasson, Robert Eggertsen, Ulf Lindblad, Sofia Dahlqvist, Henrik Imberg, Marcus Lind
CONTEXT: Diabetes and hypertension coexist in 40%-60% of individuals with type 2 diabetes. The coexistence of these two conditions is associated with increased risk of retinopathy, nephropathy and cardiovascular disease. OBJECTIVE: To investigate the prevalence of primary aldosteronism (PA) in a general cohort of persons with type 2 diabetes. DESIGN: Cross-sectional study involving six diabetes outpatient clinics in Sweden. PATIENTS: were enrolled individuals with type 2 diabetes between February 2008 and December 2013...
May 10, 2017: Clinical Endocrinology
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