[Renin and aldosterone determinations in hypertensive patients]

The diagnostic algorithm of primary aldosteronism is burdened with uncertainties and, recently, it has been suggested that the sensitivity of the aldosterone/renin ratio used as a screening test - based on the suppression aldosterone - is low.

The primary aim was to test the accuracy of aldosterone/renin ratio.

In a retrospective analysis of 309 hypertensive patients supine and ambulatory aldosterone levels were independently examined.

Aldosterone/renin ratio was elevated in 99 patients of whom 31 exhibited elevated supine aldosterone, as well. In 34 cases supine aldosterone was increased without elevation of the aldosterone/renin ratio. However, only 3 of them had concomitant low renin levels indicating that primary aldosteronism could not be ruled out. Abnormally increased renin was found in 69 patients, but only 59% of them had increased aldosterone level.

Sensitivity of aldosterone/renin ratio is high (91%) if used only in justified cases.