January - March 2011, Volume 7, Issue 1

Ceral J, Malirova E, Kopecka P, Pelouch R, Solar M

The Effect of Oral Sodium Loading and Saline Infusion on Direct Active Renin in Healthy Volunteers

Acta Endo (Buc) 2011, 7 (1): 33-38
doi: 10.4183/aeb.2011.33

Context. In patients with suspected primary aldosteronism (PA), the aldosteroneto- renin ratio (ARR) is the most frequently recommended screening test. Further evaluation is based on hormonal changes during volume expansion. Both analyses are critically dependent on an accurate estimation\r\nof renin concentration. Direct active renin (DAR) is a novel laboratory technique used for plasma renin assessment.\r\nObjective. The objective of this study was to evaluate DAR for use in PA diagnostic work-ups.\r\nSubjects and Methods. The study enrolled 69 healthy volunteers. Blood sampling was conducted before and after an\r\nincrease in oral salt intake. Furthermore, a subset of 32 individuals underwent a saline infusion suppression test. DAR and serum aldosterone were measured in all blood samples. To calculate the ARR, serum aldosterone and DAR were expressed in ng/L.\r\nResults. ARR values [median (range); 97.5 percentile] associated with normal and elevated oral salt intake were 8.4 (0.6-37.7); 26.3, and 6.8 (1.1-37.7); 19.6, respectively. DAR and serum aldosterone concentrations\r\n[median (range); 97.5 percentile] after saline infusion suppression were 2.9 (2.7-10.7); 7.2 ng/L and 30 (30-72); 54 pmol/L, respectively.\r\nConclusions. The observed values may be useful in excluding a diagnosis of PA.

Keywords: primary aldosteronism, direct active renin

Correspondence: Miroslav Solar, Department of Internal Medicine, University Hospital Hradec Kralove, Sokolska 581; 500 05 Hradec Kralove; Czech Republic, Tel: +420 495 833 3249, Fax: +420495832006, e-mail: solarmir@seznam.cz