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aldosterone to renin ratio

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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
#1
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 proved guidelines...
April 20, 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
#2
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
#3
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...
April 19, 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
#4
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
#5
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
https://www.readbyqxmd.com/read/29660263/characteristics-and-long-term-prognosis-of-patients-with-heart-failure-and-mid-range-ejection-fraction-compared-with-reduced-and-preserved-ejection-fraction-a-systematic-review-and-meta-analysis
#6
Josephine Lauritsen, Finn Gustafsson, Jawdat Abdulla
AIMS: This study aimed to assess by a meta-analysis the clinical characteristics, all-cause and cardiovascular mortality, and hospitalization of patients with heart failure (HF) with mid-range ejection fraction (HFmrEF) compared with HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). METHODS AND RESULTS: Data from 12 eligible observational studies including 109 257 patients were pooled. HFmrEF patients were significantly different and occupied a mid-position between HFrEF and HFpEF: mean age 73...
April 16, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29655877/endocrine-and-haemodynamic-changes-in-resistant-hypertension-and-blood-pressure-responses-to-spironolactone-or-amiloride-the-pathway-2-mechanisms-substudies
#7
Bryan Williams, Thomas M MacDonald, Steve V Morant, David J Webb, Peter Sever, Gordon T McInnes, Ian Ford, J Kennedy Cruickshank, Mark J Caulfield, Sandosh Padmanabhan, Isla S Mackenzie, Jackie Salsbury, Morris J Brown
BACKGROUND: In the PATHWAY-2 study of resistant hypertension, spironolactone reduced blood pressure substantially more than conventional antihypertensive drugs. We did three substudies to assess the mechanisms underlying this superiority and the pathogenesis of resistant hypertension. METHODS: PATHWAY-2 was a randomised, double-blind crossover trial done at 14 UK primary and secondary care sites in 314 patients with resistant hypertension. Patients were given 12 weeks of once daily treatment with each of placebo, spironolactone 25-50 mg, bisoprolol 5-10 mg, and doxazosin 4-8 mg and the change in home systolic blood pressure was assessed as the primary outcome...
April 11, 2018: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29617893/serum-cortisol-and-cortisone-as-potential-biomarkers-of-partial-11%C3%AE-hydroxysteroid-dehydrogenase-type-2-deficiency
#8
Cristian A Carvajal, Alejandra Tapia-Castillo, Carolina P Valdivia, Fidel Allende, Sandra Solari, Carlos F Lagos, Carmen Campino, Alejandro Martínez-Aguayo, Andrea Vecchiola, Constanza Pinochet, Claudia Godoy, Virginia Iturrieta, Rene Baudrand, Carlos E Fardella
Background: Pathogenic variations in HSD11B2 gene triggers the apparent mineralocorticoid excess syndrome (AME). There is scarce information regarding the phenotypes of subjects carrying heterozygous pathogenic variants in HSD11B2 gene. We investigated if serum cortisol/cortisone(F/E) ratio and cortisone are useful for identifying partial 11βHSD2 deficiency in those heterozygous subjects. Methods: We studied two patients diagnosed with AME and their families carrying either D223N or R213C mutation...
March 30, 2018: American Journal of Hypertension
https://www.readbyqxmd.com/read/29611836/plasma-renin-activity-to-plasma-aldosterone-concentration-ratio-for-the-assessment-of-essential-hypertensive-patients-in-real-life-clinical-practice
#9
Eugenia Gkaliagkousi, Panagiota Anyfanti, Antonios Lazaridis, Stella Douma
No abstract text is available yet for this article.
February 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29609870/-prevalence-and-relations-of-orthostatic-hypotension-in-patients-80-years-old-and-over-from-a-primary-care-unit
#10
Francisco Javier Formigo Couceiro, Marta Pena Seijo, Antonio Pose Reino, José Manuel Mayán Santos, Francisco Javier Ayape Amigot, Jesús Sueiro Justel
OBJECTIVE: To estimate the prevalence of orthostatic hypotension (OH) in patients 80 years old and over attending a primary care unit. To relate OH to the most prevalent pathologies and to the most used drugs. DESIGN: Transversal observational study. LOCATION: Primary care unit, Santiago de Compostela. PARTICIPANTS: Eighty one patients 80 years old or over representative of a primary care unit were recruited. Ten patients were excluded...
March 30, 2018: Atencion Primaria
https://www.readbyqxmd.com/read/29557106/independent-association-of-serum-aldosterone-level-with-metabolic-syndrome-and-insulin-resistance-in-korean-adults
#11
Se Hee Min, Se Hong Kim, In Kyung Jeong, Ho Chan Cho, Jin Ok Jeong, Ju Hee Lee, Hyun Jae Kang, Hyo Soo Kim, Kyong Soo Park, Soo Lim
BACKGROUND AND OBJECTIVES: A relationship between renin-angiotensin system (RAS) components and metabolic syndrome (MetS) has been suggested, but not elucidated clearly. We examined the levels of RAS components in patients with and without MetS and their association with MetS in Korean population. METHODS: This study was approved by the review boards of the participating institutions and endorsed by the Korean Society of Lipid and Atherosclerosis. We screened 892 Koreans aged ≥20 years who underwent evaluation of hypertension, diabetes, or dyslipidemia at 6 tertiary hospitals in 2015-2016...
March 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29554312/serum-potassium-and-adverse-outcomes-across-the-range-of-kidney-function-a-ckd-prognosis-consortium-meta-analysis
#12
Csaba P Kovesdy, Kunihiro Matsushita, Yingying Sang, Nigel J Brunskill, Juan J Carrero, Gabriel Chodick, Takeshi Hasegawa, Hiddo L Heerspink, Atsushi Hirayama, Gijs W D Landman, Adeera Levin, Dorothea Nitsch, David C Wheeler, Josef Coresh, Stein I Hallan, Varda Shalev, Morgan E Grams
Aims: Both hypo- and hyperkalaemia can have immediate deleterious physiological effects, and less is known about long-term risks. The objective was to determine the risks of all-cause mortality, cardiovascular mortality, and end-stage renal disease associated with potassium levels across the range of kidney function and evaluate for consistency across cohorts in a global consortium. Methods and results: We performed an individual-level data meta-analysis of 27 international cohorts [10 general population, 7 high cardiovascular risk, and 10 chronic kidney disease (CKD)] in the CKD Prognosis Consortium...
March 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29545754/angiotensin-converting-enzyme-inhibitor-has-a-protective-effect-on-decompression-sickness-in-rats
#13
Aleksandra Mazur, Anthony Guernec, Jacky Lautridou, Julie Dupas, Emmanuel Dugrenot, Marc Belhomme, Michael Theron, François Guerrero
Introduction: Commercial divers, high altitude pilots, and astronauts are exposed to some inherent risk of decompression sickness (DCS), though the mechanisms that trigger are still unclear. It has been previously showed that diving may induce increased levels of serum angiotensin converting enzyme. The renin angiotensin aldosterone system (RAAS) is one of the most important regulators of blood pressure and fluid volume. The purpose of the present study was to control the influence of angiotensin II on the appearance of DCS...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29528872/case-detection-in-primary-aldosteronism-high-diagnostic-value-of-the-aldosterone-to-renin-ratio-when-performed-under-standardized-conditions
#14
Wessel M C M Vorselaars, Gerlof D Valk, Menno R Vriens, Jan Westerink, Wilko Spiering
OBJECTIVE: The aldosterone-to-renin ratio is widely used and is the recommended screening modality for primary aldosteronism by the Endocrine Society Guideline. However, studies on its diagnostic accuracy have been inconsistent, which is mainly because of methodological limitations. We set out to evaluate this diagnostic value by using a highly standardized study protocol, which is in line with the Endocrine Society Guideline recommendations regarding indications for screening, testing conditions and reference standards in daily clinical practice...
March 9, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29526832/canagliflozin-and-heart-failure-in-type-2-diabetes-mellitus-results-from-the-canvas-program-canagliflozin-cardiovascular-assessment-study
#15
Karin Rådholm, Gemma Figtree, Vlado Perkovic, Scott D Solomon, Kenneth W Mahaffey, Dick de Zeeuw, Greg Fulcher, Terrance D Barrett, Wayne Shaw, Mehul Desai, David R Matthews, Bruce Neal
BACKGROUND : Canagliflozin is a sodium glucose cotransporter 2 inhibitor that reduces the risk of cardiovascular events. We report the effects on heart failure and cardiovascular death overall, in those with and without a baseline history of heart failure, and in other participant subgroups. METHODS : The CANVAS Program (Canagliflozin Cardiovascular Assessment Study) enrolled 10 142 participants with type 2 diabetes mellitus and high cardiovascular risk. Participants were randomly assigned to canagliflozin or placebo and followed for a mean of 188 weeks...
March 11, 2018: Circulation
https://www.readbyqxmd.com/read/29514039/a-young-patient-with-leg-weakness-and-hypokalemia-case-report
#16
Elias Andrawus, Irit Hochberg, Zaher S Azzam
A 20-year-old female patient was admitted to hospital because of bilateral leg weakness. Laboratory investigation showed metabolic alkalosis and severe hypokalemia. Differential diagnosis included mineralocorticoid or apparent mineralocorticoid excess diseases, with a high aldosterone-to-renin ratio (ARR) after correcting hypokalemia. After confirmatory tests, imaging studies revealed a unilateral adrenocortical adenoma consistent with Conn's disease. Surgery was curative.
February 1, 2018: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29513563/chronic-hypertension-in-pregnancy-the-impact-of-ethnicity-and-superimposed-preeclampsia-on-placental-endothelial-and-renal-biomarkers
#17
Louise Mary Webster, Carolyn Gill, Paul T Seed, Kate Bramham, Cornelia Wiesender, Catherine Nelson-Piercy, Jenny E Myers, Lucy C Chappell
Black ethnicity is associated with worse pregnancy outcomes in women with chronic hypertension. Pre-existing endothelial and renal dysfunction, and poor placentation may contribute but pathophysiological mechanisms underpinning increased risk are poorly understood. This cohort study aimed to investigate the relationship between ethnicity, superimposed pre-eclampsia and longitudinal changes in markers of endothelial, renal and placental dysfunction in women with chronic hypertension. Plasma concentrations of placental growth factor (PlGF), syndecan-1, renin, aldosterone, and urinary angiotensinogen:creatinine ratio (AGTCR), protein:creatinine ratio (PCR) and albumin:creatinine ratio (ACR) were quantified during pregnancy and postpartum in women with chronic hypertension...
March 7, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29506854/spectral-analysis-of-heart-rate-variability-predicts-mortality-and-instability-from-vascular-injury
#18
Kiavash R Koko, Brian D McCauley, John P Gaughan, Marc W Fromer, Ryan S Nolan, Ashleigh L Hagaman, Spencer A Brown, Joshua P Hazelton
BACKGROUND: Spectral analysis of continuous blood pressure and heart rate variability provides a quantitative assessment of autonomic response to hemorrhage. This may reveal markers of mortality as well as endpoints of resuscitation. METHODS: Fourteen male Yorkshire pigs, ranging in weight from 33 to 36 kg, were included in the analysis. All pigs underwent laparotomy and then sustained a standardized retrohepatic inferior vena cava injury. Animals were then allowed to progress to class 3 hemorrhagic shock and where then treated with abdominal sponge packing followed by 6 h of crystalloid resuscitation...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29506523/cardiovascular-magnetic-resonance-measures-of-aortic-stiffness-in-asymptomatic-patients-with-type-2-diabetes-association-with-glycaemic-control-and-clinical-outcomes
#19
Peter P Swoboda, Bara Erhayiem, Rachel Kan, Adam K McDiarmid, Pankaj Garg, Tarique A Musa, Laura E Dobson, Klaus K Witte, Mark T Kearney, Julian H Barth, Ramzi Ajjan, John P Greenwood, Sven Plein
BACKGROUND: We aimed to investigate in patients with type 2 diabetes whether aortic stiffness is: (i) associated with glycaemic control, (ii) associated with adverse outcomes and (iii) can be reversed on treatment with RAAS inhibition. METHODS: Patients with type 2 diabetes (N = 94) and low vascular risk underwent assessment of cardiovascular risk and CMR assessment of ascending aortic distensibility (AAD), descending aortic distensibility (DAD) and aortic pulse wave velocity (PWV)...
March 5, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29501807/natriuretic-peptides-as-biomarkers-of-treatment-response-in-clinical-trials-of-heart-failure
#20
Muthiah Vaduganathan, Brian Claggett, Milton Packer, John J V McMurray, Jean L Rouleau, Michael R Zile, Karl Swedberg, Scott D Solomon
OBJECTIVES: This study sought to determine whether treatment-related changes in natriuretic peptides (NPs) predict longer-term therapeutic effects in clinical trials of heart failure (HF). BACKGROUND: The lack of reliable predictors of efficacy of drugs and devices in HF has presented a major hurdle to the development and evaluation of novel therapies. METHODS: The study conducted a trial-level analysis of 16 phase III chronic HF trials completed between 1987 and 2013 studying 18 therapeutic comparisons in 48,844 patients...
March 4, 2018: JACC. Heart Failure
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