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aldosterone to renin ratio

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https://www.readbyqxmd.com/read/29908836/dopps-data-suggest-a-possible-survival-benefit-of-renin-angiotensin-aldosterone-system-inhibitors-and-other-antihypertensive-medications-for-hemodialysis-patients
#1
Angelo Karaboyas, Hairong Xu, Hal Morgenstern, Francesco Locatelli, Michel Jadoul, Kosaku Nitta, Indranil Dasgupta, Francesca Tentori, Friedrich K Port, Bruce M Robinson
The benefits of renin angiotensin-aldosterone system inhibitors (RAASi) are well-established in the general population, particularly among those with diabetes, congestive heart failure (CHF), or coronary artery disease (CAD). However, conflicting evidence from trials and concerns about hyperkalemia limit RAASi use in hemodialysis patients, relative to other antihypertensive agents, including beta blockers and calcium channel blockers. Therefore, we investigated prescription patterns and associations with mortality for RAASi and other antihypertensive agents using data from the international Dialysis Outcomes and Practice Patterns Study (DOPPS)...
June 13, 2018: Kidney International
https://www.readbyqxmd.com/read/29898478/-canine-hypoadrenocorticism-an-update-on-pathogenesis-diagnosis-and-treatment
#2
Katja Kalenyak, Romy M Heilmann
Canine hypoadrenocorticism (HoAC) results from a loss of functional adrenal cortex, the most common etiology of which is an immune-mediated destruction leading to an inadequate production of glucocorticoids and mineralocorticoids. The term "atypical" HoAC is used for a subgroup of dogs with either an isolated glucocorticoid deficiency or a combined glucocorticoid and mineralocorticoid deficiency but normal electrolytes. Dogs with HoAC can present with a large variety of clinical signs, ranging from shaking, weakness, and mild gastrointestinal signs to seizures, hypovolemic shock, and collapse...
June 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/29873811/saline-suppression-test-parameters-may-predict-bilateral-subtypes-of-primary-aldosteronism
#3
Hikaru Hashimura, Jimmy Shen, Peter J Fuller, Nicholas Y N Chee, James C G Doery, Winston Chong, Kay Weng Choy, Stella May Gwini, Jun Yang
BACKGROUND: The saline suppression test (SST) serves to confirm the diagnosis of primary aldosteronism (PA) while adrenal vein sampling (AVS) is used to determine whether the aldosterone hypersecretion is unilateral or bilateral. An accurate prediction of bilateral PA based on SST results could reduce the need for AVS. AIM: We sought to identify SST parameters that reliably predict bilateral PA. METHODS: The results from 121 patients undergoing SSTs at Monash Health from January 2010 to January 2018 including screening blood tests, imaging, AVS and histopathology results were evaluated...
June 6, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29808753/efficacy-of-renin-angiotensin-system-inhibitors-for-patients-with-heart-failure-with-preserved-ejection-fraction-and-mild-to-moderate-chronic-kidney-disease
#4
Tetsuro Tsujimoto, Hiroshi Kajio
Background Renin-angiotensin system (RAS) inhibitors are first-line treatments for chronic kidney disease, but it is not known if these agents can improve outcome in patients with heart failure with preserved ejection fraction (HFpEF) and chronic kidney disease. Design This was a post-hoc analysis of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. Methods The primary outcome was a composite endpoint of all-cause death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for heart failure...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29789689/postmenopausal-osteoporosis-is-associated-with-elevated-aldosterone-renin-ratio
#5
Xiaoyu Shu, Mei Mei, Linqiang Ma, Zhihong Wang, Shumin Yang, Jinbo Hu, Ying Song, Wenwen He, Ting Luo, Qingfeng Cheng, Yue Wang, Qianna Zhen, Qifu Li
Plasma aldosterone/renin ratio (ARR) is a useful method for primary aldosteronism (PA) screening. However some confounders, such as medications and dietary, affect plasma renin and aldosterone levels, resulting in false-negative or -positive plasma ARR. This study investigated the association between postmenopausal osteoporosis (PMO) and plasma ARR. Bone mineral density (BMD) was measured by dual-energy X-ray-absorptiometry (DXA) in 324 normotensive postmenopausal women. Based on clinical characteristics and BMD, 186 and 96 subjects were diagnosed as PMO and osteopenia respectively, and the remaining 42 subjects were grouped as normal BMD...
May 22, 2018: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29788258/is-the-plasma-aldosterone-to-renin-ratio-associated-with-blood-pressure-response-to-treatment-in-general-practice
#6
Sabine C Käyser, Bianca W M Schalk, Wim J C de Grauw, Tjard R Schermer, Reinier P Akkermans, Jacques W M Lenders, Jaap Deinum, Marion C J Biermans
Background: Individualized antihypertensive treatment based on specific biomarkers such as renin may lead to more effective blood pressure control in patients with newly diagnosed essential hypertension. Recent studies suggested that the plasma aldosterone-to-renin ratio (ARR) may also be a candidate predictor for this purpose. Objective: To assess whether the ARR is associated with the blood pressure response to antihypertensive treatment in patients with newly diagnosed hypertension...
May 19, 2018: Family Practice
https://www.readbyqxmd.com/read/29781840/cardiovascular-autonomic-profile-in-women-with-constitutional-hypotension
#7
Giris Jacob, Franca Barbic, Meytal Glago, Franca Dipaola, Alberto Porta, Raffaello Furlan
BACKGROUND: Constitutional hypotension (CHT) is defined as a SBP below 105 mmHg. As autonomic-related symptoms are frequently reported in CHT, these symptoms suggest that the cardiovascular autonomic control is perturbed in individuals with CHT. METHODS: We investigated the autonomic cardiovascular control of 15 women with CHT and 12 women with NBP (SBP >110 mmHg). We monitored BP and ECG for autonomic function test. Supine and head up tilt (HUT) spectral analysis of RR interval and BP variability, baroreflex sensitivity and plasma levels of plasma renin activity and aldosterone were determined...
May 16, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29779118/change-in-kidney-function-after-unilateral-adrenalectomy-in-patients-with-primary-aldosteronism-identification-of-risk-factors-for-decreased-kidney-function
#8
Il Young Kim, In Seong Park, Min Jeong Kim, Miyeun Han, Harin Rhee, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak, Sang Heon Song, Hyun Chul Chung
PURPOSE: Glomerular filtration rate (GFR) has been reported to decrease after unilateral adrenalectomy in patients with primary aldosteronism (PA). The aim of this study was to identify clinical predictors for decreased GFR after adrenalectomy in patients with PA. METHODS: The records of 187 patients (98 patients with PA and 89 with non-PA adrenal disease) who were followed up for at least 6 months after unilateral adrenalectomy were retrospectively analyzed. Estimated GFR (eGFR) was investigated at 1, 3, and 6 months postoperatively...
May 19, 2018: International Urology and Nephrology
https://www.readbyqxmd.com/read/29774167/complete-hypokalemic-quadriparesis-as-a-first-presentation-of-sj%C3%A3-gren-syndrome
#9
Jason An, Branko Braam
Rationale: We hope to increase awareness that hypokalemic paralysis may be the first presentation of Sjögren syndrome, for which potassium-sparing diuretics can be an effective adjunct to potassium replenishment. Presenting concerns: A 73-year-old female presented to a peripheral hospital with quadriparesis and a critically low serum potassium of 1.6 mmol/L with U waves on the electrocardiogram (ECG). The initial arterial blood gas showed a pH of 7.19, bicarbonate of 13 mEq/L, and a CO2 of 35 mm Hg...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29771450/effects-of-intense-aerobic-exercise-and-or-antihypertensive-medication-in-individuals-with-metabolic-syndrome
#10
M Ramirez-Jimenez, F Morales-Palomo, J F Ortega, R Mora-Rodriguez
We studied the blood pressure lowering effects of a bout of exercise and/or antihypertensive medicine with the goal of studying if exercise could substitute or enhance pharmacologic hypertension treatment. Twenty-three hypertensive metabolic syndrome patients chronically medicated with angiotensin II receptor 1 blockade antihypertensive medicine underwent 24-hr monitoring in four separated days in a randomized order; a) after taking their habitual dose of antihypertensive medicine (AHM trial), b) substituting their medicine by placebo medicine (PLAC trial), c) placebo medicine with a morning bout of intense aerobic exercise (PLAC+EXER trial) and d) combining the exercise and antihypertensive medicine (AHM+EXER trial)...
May 17, 2018: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/29767556/hydronephrosis-is-associated-with-elevated-plasmin-in-urine-in-pediatric-patients-and-rats-and-changes-in-ncc-and-%C3%AE-enac-abundance-in-rat-kidney
#11
Rikke Zachar, Ammar Al-Mashhadi, Henrik Dimke, Per Svenningsen, Boye L Jensen, Mattias Carlström
Obstruction of urine flow at the level of the pelvo-ureteric junction (UPJO) and subsequent development of hydronephrosis is one of the most common congenital renal malformations. UPJO is associated with development of salt-sensitive hypertension, which is set by the obstructed kidney, and with a stimulated renin-angiotensin-aldosterone system (RAAS) in rodent models. This study aimed at investigating the hypothesis that i) in pediatric patients with UPJO the RAAS is activated prior to surgical relief of the obstruction; ii) in rats with UPJO the RAAS activation is reflected by increased abundance of renal aldosterone-stimulated Na+ transporters; and iii) the injured UPJO kidney allows aberrant filtration of plasminogen leading to proteolytic activation of the epithelial sodium channel gamma subunit (γ-ENaC)...
May 16, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29733445/effects-of-treatment-with-an-angiotensin-2-receptor-blocker-and-or-vitamin-d3-on-parathyroid-hormone-and-aldosterone-a-randomized-placebo-controlled-trial
#12
Lise Sofie Bislev, Lene Langagergaard Rødbro, Jesper Nørgaard Bech, Erling Bjerregaard Pedersen, Lars Rolighed, Tanja Sikjaer, Lars Rejnmark
OBJECTIVE: Emerging evidence support a positive, bidirectional and clinical relevant interaction between parathyroid hormone (PTH) and the renin-angiotensin-aldosterone-system (RAAS). A beneficial effect of the widely used RAAS inhibitors might include a PTH lowering effect, as high PTH levels may be harmful to cardiovascular health. We aimed to investigate whether PTH levels are lowered by short-term treatment with an angiotensin 2 receptor blocker (valsartan) independently of co-administration of vitamin D3...
May 7, 2018: Clinical Endocrinology
https://www.readbyqxmd.com/read/29730248/cost-effectiveness-analysis-of-renin-angiotensin-aldosterone-system-blockade-in-progression-of-chronic-kidney-disease
#13
Oraluck Pattanaprateep, Atiporn Ingsathit, Mark McEvoy, John Attia, Ammarin Thakkinstian
OBJECTIVES: To assess the cost effectiveness of renin-angiotensin aldosterone system (RAAS) blockade in the progression of chronic kidney disease using Thai clinical data in 2014. METHODS: A Markov model for cost-effectiveness analysis was applied to estimate from a societal perspective the cost per quality-adjusted life-year (QALY) gained and the incremental cost-effectiveness ratio of RAAS versus non-RAAS used in preventing the progression of end-stage renal disease and death stratified by diabetic and nondiabetic patients...
May 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29723896/mineralocorticoid-receptor-blockers-and-aldosterone-to-renin-ratio-a-randomized-controlled-trial-and-observational-data
#14
Stefan Pilz, Christian Trummer, Nicolas Verheyen, Verena Schwetz, Marlene Pandis, Felix Aberer, Martin R Grübler, Andreas Meinitzer, Antonia Bachmann, Jakob Voelkl, Ioana Alesutan, Cristiana Catena, Leonardo A Sechi, Winfried März, Barbara Obermayer-Pietsch, Andreas Tomaschitz
Current guidelines recommend to withdraw mineralocorticoid receptor (MR) blocker treatment for at least 4 weeks when measuring the aldosterone to renin ratio (ARR) as a screening test for primary aldosteronism (PA). We aimed to evaluate the effect of MR blocker treatment on ARR and its components, plasma aldosterone concentration (PAC), and direct renin concentration (DRC). First, we performed a post-hoc analysis of the effect of eplerenone on parathyroid hormone levels in primary hyperparathyroidism (EPATH) study, a randomized controlled trial (RCT) in 110 patients with primary hyperparathyroidism (pHPT)...
May 2018: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/29688582/single-and-multiple-dose-escalation-study-to-assess-pharmacokinetics-pharmacodynamics-and-safety-of-oral-esaxerenone-in-healthy-japanese-subjects
#15
Manabu Kato, Hidetoshi Furuie, Takako Shimizu, Atsuhiro Miyazaki, Fumiaki Kobayashi, Hitoshi Ishizuka
AIMS: To characterize the pharmacokinetics, pharmacodynamics and safety of esaxerenone, a mineralocorticoid receptor antagonist, in healthy adult Japanese men. METHODS: Double-blind, placebo-controlled, sequential, dose-escalation studies were conducted in subjects randomized to receive oral once-daily esaxerenone (ranges: 5-200 mg [single-dose]; 10-100 mg over 10 days [multiple-dose]) or placebo under fasting conditions. Plasma concentrations were analysed by liquid chromatograph-tandem mass spectrometry...
April 24, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29684370/analytical-validation-and-investigation-on-reference-intervals-of-aldosterone-and-renin-in-chinese-han-population-by-using-fully-automated-chemiluminescence-immunoassays
#16
Lingyan Deng, Zhigang Xiong, Huijun Li, Xiaomei Lei, Liming Cheng
BACKGROUND: The aldosterone/renin ratio (ARR) is recommended to screen for primary aldosteronism (PA) in hypertension. We estimated fully automated chemiluminescence immunoassays (CLIA) for plasma aldosterone concentrations (PAC) and plasma direct renin concentrations (PRC) and investigated their reference intervals in Chinese Han population. METHODS: PAC and PRC were measured on a fully automated analyzer (LIAISON XL, DiaSorin, Italy). Performance characteristics were estimated according to CLSI approved guidelines...
June 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29677050/changes-in-albuminuria-and-renal-outcome-in-patients-with-type-2-diabetes-and-hypertension-a-real-life-observational-study
#17
Francesca Viazzi, Antonio Ceriello, Paola Fioretto, Carlo Giorda, Pietro Guida, Giuseppina Russo, Eulalia Greco, Salvatore De Cosmo, Roberto Pontremoli
OBJECTIVES: To assess the predictive role of changes in albuminuria on the loss of renal function under antihypertensive treatment in patients with type 2 diabetes (T2D). METHODS: Clinical records from a total of 12 611 patients with hypertension and T2D, attending 100 antidiabetic centers in Italy, with normal estimated glomerular filtration rate (eGFR) at baseline and regular visits during a 4-year period were retrieved and analyzed. We assessed the association between changes in albuminuria status during a 1-year baseline period and time updated blood pressure (BP) and eGFR loss over the subsequent 4-year follow-up...
April 19, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29677048/criteria-for-diagnosing-primary-aldosteronism-on-the-basis-of-liquid-chromatography-tandem-mass-spectrometry-determinations-of-plasma-aldosterone-concentration
#18
Stephanie Baron, Laurence Amar, Anne-Laure Faucon, Anne Blanchard, Laurence Baffalie, Catherine Faucard, Simon Travers, Jean-Yves Pagny, Michel Azizi, Pascal Houillier
BACKGROUND: Primary aldosteronism is affecting about 10% of hypertensive patients. Primary aldosteronism should be diagnosed by screening tests based on plasma aldosterone concentration (PAC) and aldosterone-to-renin ratio (ARR), followed by confirmatory test. The cutoff values for PAC and ARR depend on PAC and plasma renin measurement methods. Liquid chromatography-tandem mass spectrometry (LC-MS/MS), the new gold standard method for aldosterone determination, is now widespread but shows lower values than immunoassays...
July 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29674401/licorice-induced-apparent-mineralocorticoid-excess-compounded-by-excessive-use-of-terbutaline-and-high-water-intake
#19
Laust Frisenberg Buhl, Frederik Nørregaard Pedersen, Marianne Skovsager Andersen, Dorte Glintborg
This case highlights the clinical course of a 54-year-old male patient presenting with hypertension and long-term refractory hypokalaemia. He reported long-term malaise, fatigue and physical discomfort. Diarrhoea, vomiting, over-the-counter drugs, dietary supplements and any kind of medical abuse were all denied. Physical examination was normal. Suppressed plasma renin activity along with a low aldosterone level and elevated urinary cortisone/cortisol metabolite excretion ratio raised the suspicion of apparent mineralocorticoid excess (AME)...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29665833/intervention-using-vitamin-d-for-elevated-urinary-albumin-in-type-2-diabetes-mellitus-ideal-2-study-study-protocol-for-a-randomised-controlled-trial
#20
Shahrad Taheri, Muhammad Asim, Hassan Al Malki, Omar Fituri, Manikkam Suthanthiran, Phyllis August
BACKGROUND: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. T2DM is associated with serious macro- and microvascular complications. In particular, diabetic kidney disease (DKD), which begins with excessive urinary albumin excretion, has a significant impact on affected individuals and is costly to healthcare services. Inhibition of the renin-angiotensin-aldosterone system (RAAS) with angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) significantly reduces albuminuria in diabetes, but this effect is not observed in all those treated...
April 17, 2018: Trials
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