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Aldosterone/Renin ratio (ep) (EDTA plasma, frozen (ep))

Testcode:	ARQT_G
Specimens:	1 ml EDTA plasma, frozen (ep)
includes following tests:	Aldosterone (ep) (EDTA plasma, frozen (ep)) Renin (ep) (EDTA plasma, frozen (ep))
Preanalytics/Notes:	Patients must stop taking the following antihypertensive agents before the ARR is determined: Spironolactone, eplerenone, drospirenone, amiloride, triamterene: at least 4 weeks prior to blood sampling. Beta-blockers, AT2 antagonists, loop diuretics, central alpha-2-receptor-Agonists (Clonidine, alpha-Methyl-Dopa), ACE-Inhibitors, Renin Inhibitors, Calcium Antagonists (DHP-Type): at least 2 weeks prior to blood sampling. Thiazide diuretics, Calcium antagonists (i.e. verapamil slow release) and alphareceptor blockers (e.g. Doxazosin) do not significantly interfere with diagnosis. Blood sampling (EDTA blood) in seated patients in the morning (8 - 10 am) after a resting period of 15 minutes while seated. Before that, the patient should have been awake for at least 2 hours in an upright position (sitting, standing or walking). As hypokaliaemia leads to false-positive results, it may be necessary to balance it beforehand through potassium substitution. Sodium should not be restricted in the period before blood sampling (sufficient NaCl). EDTA plasma should be prepared after sampling by centrifugation; supernatant EDTA plasma is transferred into a new tube which is labelled accordingly, frozen and dispatched frozen. Caution! Do not store EDTA plasma at 2 - 8 °C, do not cool sample before freezing, but quickly process at room temperature. Cryoactivation may lead to a production of active renin from prorenin (10 times higher plasma concentration than renin) and thus result in false high renin values.
Set-up:	on demand
Duration:	1 day
Indication/Significance:	For the following groups of patients an optimised PH screening (primary hyperaldosteronism) with additional determination of the aldosterone/renin ratio (ARR) is recommended: sustained blood pressure (BP) above 150/100 mm Hg on each of three measurements obtained on different days hypertension (BP > 140/90 mm Hg) resistant to three conventional antihypertensive drugs (including a diuretic) controlled BP (< 140/90 mm Hg) on four or more antihypertensive drugs hypertension and spontaneous or diuretic induced hypokalemia hypertension and adrenal incidentaloma hypertension and sleep apnea hypertension and a family history of early onset hypertension or cerebrovascular accident at a young age (< 40 years) all hypertensive first-degree relatives of patients with PH
Interpretation:	With an ARR > 19 in more… With an ARR > 19 in connection with an aldosterone value > 15 ng/dl in upright sitting posture, primary hyperaldosteronism is suspected. An aldosterone value of 15 ng/dl with a simultaneously increase ARR of > 19 may, in rare cases, also be an indication of primary hyperaldosteronism. The diagnosis should first be confirmed by a confirmatory test (e.g. NaCl stress test). Subsequently further clarification with regard to the underlying aetiology and resulting therapy by means of biochemical and imaging procedures. close

Reference range / valuation (openclose)

both sex
	< 19,0

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Abrechnung GOÄ

Die Kosten werden für den i. d. R. genutzten 1,15-fachen GOÄ-Satz dargestellt. Wird die Untersuchung nicht in Ihrem regionalen Labor durchgeführt, erfolgt die Analyse in dem Labor, das im Leistungsverzeichnis genannt ist. In diesem Fall gilt der dort für die Untersuchung angegebene Preis.