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Elevated aldosterone:renin ratio

MedGen UID:
1864103
•Concept ID:
C5937119
•
Finding
HPO: HP:6000318

Definition

The ratio of aldosterone concentration to renin concentration is above the upper limit of normal. If aldosterone is expressed in ng/dl and plasma renin activity is expressed as ng/ml/hr, then values above 20 with aldosterone level above 15 are considered indicative of primary aldosteronism. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVElevated aldosterone:renin ratio

Conditions with this feature

Hyperaldosteronism, familial, type IV
MedGen UID:
934723
•Concept ID:
C4310756
•
Disease or Syndrome
See: Condition Record
Hyperaldosteronism, familial, type IV

Professional guidelines

PubMed

Primary Aldosteronism.
Quencer KB, Rugge JB, Senashova O
Am Fam Physician 2023 Sep;108(3):273-277. PMID: 37725461
Isradipine therapy in Cacna1dIle772Met/+ mice ameliorates primary aldosteronism and neurologic abnormalities.
Stölting G, Dinh HA, Volkert M, Hellmig N, Schewe J, Hennicke L, Seidel E, Oberacher H, Zhang J, Lifton RP, Urban I, Long M, Rivalan M, Nottoli T, Scholl UI
JCI Insight 2023 Oct 23;8(20) doi: 10.1172/jci.insight.162468. PMID: 37698934Free PMC Article
Suppression of Aldosterone Secretion After Recumbent Saline Infusion Does Not Exclude Lateralized Primary Aldosteronism.
Cornu E, Steichen O, Nogueira-Silva L, Küpers E, Pagny JY, Grataloup C, Baron S, Zinzindohoue F, Plouin PF, Amar L
Hypertension 2016 Oct;68(4):989-94. Epub 2016 Sep 6 doi: 10.1161/HYPERTENSIONAHA.116.07214. PMID: 27600182

Recent clinical studies

Etiology

Primary Aldosteronism.
Quencer KB, Rugge JB, Senashova O
Am Fam Physician 2023 Sep;108(3):273-277. PMID: 37725461
Primary Aldosteronism More Prevalent in Patients With Cardioembolic Stroke and Atrial Fibrillation.
Nguyen V, Tu TM, Mamauag MJB, Lai J, Saffari SE, Aw TC, Ong L, Foo RSY, Chai SC, Fones S, Zhang M, Puar TH
Front Endocrinol (Lausanne) 2022;13:869980. Epub 2022 Apr 19 doi: 10.3389/fendo.2022.869980. PMID: 35518929Free PMC Article
Diagnosis of primary hyperaldosteronism.
Araujo-Castro M, Parra-Ramírez P
Med Clin (Barc) 2022 May 13;158(9):424-430. Epub 2021 Dec 16 doi: 10.1016/j.medcli.2021.10.012. PMID: 34924198
Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio.
Shu X, Mei M, Ma L, Wang Z, Yang S, Hu J, Song Y, He W, Luo T, Cheng Q, Wang Y, Zhen Q, Li Q; Chongqing Primary Aldosteronism Study(CONPASS) Group
J Hum Hypertens 2018 Jul;32(7):524-530. Epub 2018 May 22 doi: 10.1038/s41371-018-0069-7. PMID: 29789689
Suppression of Aldosterone Secretion After Recumbent Saline Infusion Does Not Exclude Lateralized Primary Aldosteronism.
Cornu E, Steichen O, Nogueira-Silva L, Küpers E, Pagny JY, Grataloup C, Baron S, Zinzindohoue F, Plouin PF, Amar L
Hypertension 2016 Oct;68(4):989-94. Epub 2016 Sep 6 doi: 10.1161/HYPERTENSIONAHA.116.07214. PMID: 27600182

Diagnosis

Diagnosis and Management of Adrenocortical Carcinoma with Co-secretion of Cortisol and Aldosterone: A Case Report.
Aliño MM, Tam-Go LM
J ASEAN Fed Endocr Soc 2024;39(2):103-107. Epub 2024 Aug 27 doi: 10.15605/jafes.039.02.13. PMID: 39620173Free PMC Article
Primary Aldosteronism.
Quencer KB, Rugge JB, Senashova O
Am Fam Physician 2023 Sep;108(3):273-277. PMID: 37725461
Primary Aldosteronism More Prevalent in Patients With Cardioembolic Stroke and Atrial Fibrillation.
Nguyen V, Tu TM, Mamauag MJB, Lai J, Saffari SE, Aw TC, Ong L, Foo RSY, Chai SC, Fones S, Zhang M, Puar TH
Front Endocrinol (Lausanne) 2022;13:869980. Epub 2022 Apr 19 doi: 10.3389/fendo.2022.869980. PMID: 35518929Free PMC Article
Diagnosis of primary hyperaldosteronism.
Araujo-Castro M, Parra-Ramírez P
Med Clin (Barc) 2022 May 13;158(9):424-430. Epub 2021 Dec 16 doi: 10.1016/j.medcli.2021.10.012. PMID: 34924198
Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio.
Shu X, Mei M, Ma L, Wang Z, Yang S, Hu J, Song Y, He W, Luo T, Cheng Q, Wang Y, Zhen Q, Li Q; Chongqing Primary Aldosteronism Study(CONPASS) Group
J Hum Hypertens 2018 Jul;32(7):524-530. Epub 2018 May 22 doi: 10.1038/s41371-018-0069-7. PMID: 29789689

Therapy

Double hit! A unique case of resistant hypertension.
DeCarlo KE, Agrawal N
BMJ Case Rep 2017 Dec 22;2017 doi: 10.1136/bcr-2017-221530. PMID: 29275380Free PMC Article
Suppression of Aldosterone Secretion After Recumbent Saline Infusion Does Not Exclude Lateralized Primary Aldosteronism.
Cornu E, Steichen O, Nogueira-Silva L, Küpers E, Pagny JY, Grataloup C, Baron S, Zinzindohoue F, Plouin PF, Amar L
Hypertension 2016 Oct;68(4):989-94. Epub 2016 Sep 6 doi: 10.1161/HYPERTENSIONAHA.116.07214. PMID: 27600182
TASK-3 channel deletion in mice recapitulates low-renin essential hypertension.
Guagliardo NA, Yao J, Hu C, Schertz EM, Tyson DA, Carey RM, Bayliss DA, Barrett PQ
Hypertension 2012 May;59(5):999-1005. Epub 2012 Apr 9 doi: 10.1161/HYPERTENSIONAHA.111.189662. PMID: 22493079Free PMC Article
The spironolactone, amiloride, losartan, and thiazide (SALT) double-blind crossover trial in patients with low-renin hypertension and elevated aldosterone-renin ratio.
Hood SJ, Taylor KP, Ashby MJ, Brown MJ
Circulation 2007 Jul 17;116(3):268-75. Epub 2007 Jul 2 doi: 10.1161/CIRCULATIONAHA.107.690396. PMID: 17606839

Prognosis

Analysis of postoperative biochemical values and clinical outcomes after adrenalectomy for primary aldosteronism.
Swearingen AJ, Kahramangil B, Monteiro R, Krishnamurthy V, Jin J, Shin J, Siperstein A, Berber E
Surgery 2018 Apr;163(4):807-810. Epub 2017 Dec 15 doi: 10.1016/j.surg.2017.10.045. PMID: 29249599
Suppression of Aldosterone Secretion After Recumbent Saline Infusion Does Not Exclude Lateralized Primary Aldosteronism.
Cornu E, Steichen O, Nogueira-Silva L, Küpers E, Pagny JY, Grataloup C, Baron S, Zinzindohoue F, Plouin PF, Amar L
Hypertension 2016 Oct;68(4):989-94. Epub 2016 Sep 6 doi: 10.1161/HYPERTENSIONAHA.116.07214. PMID: 27600182

Clinical prediction guides

Diagnosis and Management of Adrenocortical Carcinoma with Co-secretion of Cortisol and Aldosterone: A Case Report.
Aliño MM, Tam-Go LM
J ASEAN Fed Endocr Soc 2024;39(2):103-107. Epub 2024 Aug 27 doi: 10.15605/jafes.039.02.13. PMID: 39620173Free PMC Article
Diagnosis of primary hyperaldosteronism.
Araujo-Castro M, Parra-Ramírez P
Med Clin (Barc) 2022 May 13;158(9):424-430. Epub 2021 Dec 16 doi: 10.1016/j.medcli.2021.10.012. PMID: 34924198
Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio.
Shu X, Mei M, Ma L, Wang Z, Yang S, Hu J, Song Y, He W, Luo T, Cheng Q, Wang Y, Zhen Q, Li Q; Chongqing Primary Aldosteronism Study(CONPASS) Group
J Hum Hypertens 2018 Jul;32(7):524-530. Epub 2018 May 22 doi: 10.1038/s41371-018-0069-7. PMID: 29789689
Analysis of postoperative biochemical values and clinical outcomes after adrenalectomy for primary aldosteronism.
Swearingen AJ, Kahramangil B, Monteiro R, Krishnamurthy V, Jin J, Shin J, Siperstein A, Berber E
Surgery 2018 Apr;163(4):807-810. Epub 2017 Dec 15 doi: 10.1016/j.surg.2017.10.045. PMID: 29249599

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