アルドステロン・レニン比
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2020/08/23 06:27:16」(JST)
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Aldosterone-to-renin ratio (ARR) is the mass concentration of aldosterone divided by the plasma renin activity or by serum renin concentration in blood. The aldosterone/renin ratio is recommended as screening tool for primary hyperaldosteronism.[1]
Interpretation
Aldosterone-to-renin ratio can be given in ng/dL per ng/(mL·h), that is, nanogram per deciliter of aldosterone per nanogram per (milliliter x hour) of renin. Also, it can be given in pmol/liter per µg/(liter·h), where aldosterone is given in molar concentration. The former can be converted to the latter by multiplying by 27.6. Also, the inverse value is occasionally given, that is, the renin-to-aldosterone ratio, whose value is the multiplicative inverse of the aldosterone-to-renin ratio.
The cutoff normal individuals from those with primary hyperaldosteronism is significantly affected by the conditions of testing, such as posture and time of day. On average, an ARR cutoff of 23.6 ng/dL per ng/(mL·h), expressed in alternative units as 651 pmol/liter per µg/(liter·h), has been estimated to have a sensitivity of 97% and specificity of 94%.[2] An ARR value in an individual that is higher than the cutoff indicates primary hyperaldosteronism.
If the inverse ratio (i.e. renin-to-aldosterone) ratio is used, a value lower than the cutoff indicates primary hyperaldosteronism.
Cutoffs used to distinguish primary hyperaldosteronism from normal individuals
| Aldosterone-to-renin ratio
|
|
Renin-to-aldosterone ratio
|
| Value |
Unit |
|
Value |
Unit
|
| 13.1,[1] 23.6,[2] 35.0[1] |
ng/dl per ng/(ml·h) |
|
0.029, 0.042, 0.076 |
ng/(ml·h) per ng/dl
|
| 362, 651, 966 |
pmol/liter per µg/(liter·h) |
|
0.0010, 0.0015, 0.0028 |
µg/(liter·h) per pmol/liter
|
See also
References
- ^ a b c Tiu, S. -C.; Choi, C. -H.; Shek, C. -C.; Ng, Y. -W.; Chan, F. K. W.; Ng, C. -M.; Kong, A. P. S. (2004). "The Use of Aldosterone-Renin Ratio as a Diagnostic Test for Primary Hyperaldosteronism and Its Test Characteristics under Different Conditions of Blood Sampling". Journal of Clinical Endocrinology & Metabolism. 90: 72–78. doi:10.1210/jc.2004-1149. PMID 15483077. [1]
- ^ a b Aldosterone-Renin Ratio in Primary Hyperaldosteronism by Allan S. Brett. Posted: 03/15/2005; Journal Watch. 2005;4(2)
UpToDate Contents
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- 1. 原発性アルドステロン症の診断diagnosis of primary aldosteronism [show details]
…retrospective, multicenter review, more widespread use of the plasma aldosterone to renin ratio (plasma aldosterone concentration/plasma renin activity [PAC/PRA] ratio) as a case-detection test in hypertensive patients …
- 2. 副腎疾患におけるレニン-アンギオテンシン-アルドステロン系の評価assays of the renin angiotensin aldosterone system in adrenal disease [show details]
…result, guidelines advocate screening for primary aldosteronism by measurement of the plasma aldosterone/renin ratio rather than that of plasma potassium (which is much less sensitive) and among a much wider …
- 3. 原発性アルドステロン症の病態生理および臨床的特徴pathophysiology and clinical features of primary aldosteronism [show details]
…earlier diagnosis as more patients with hypertension are being screened with the plasma aldosterone to plasma renin activity ratio as a case-detection test for primary aldosteronism . In a retrospective, international…
- 4. 治療抵抗性高血圧の定義、危険因子、および評価definition risk factors and evaluation of resistant hypertension [show details]
…to determine whether the patient has an elevated or high-normal PAC, suppressed PRA, and elevated PAC/PRA ratio. Certain antihypertensive drugs can alter the ratio, some of which should be discontinued prior…
- 5. 原発性アルドステロン症の治療treatment of primary aldosteronism [show details]
English Journal
Japanese Journal
- 内分泌性高血圧 (特集 高血圧診療update : 診断・治療の最新動向) -- (高血圧の最新治療 JSH2019ガイドラインを踏まえて)
- 柴田 洋孝
- 日本臨床 = Japanese journal of clinical medicine 78(2), 321-327, 2020-02
- NAID 40022146091
- 財津 將嘉,吉原 達也,久保田 史郎
- 日本健康開発雑誌 41(0), 73-78, 2020
- … また、長期効果として、妊婦11640名の既存データを用いて、妊娠高血圧症に対するプール歩行のprevalence ratioをポワソン回帰分析およびロバスト分散で推計した。 … 一方、妊娠高血圧症に対するプール歩行の長期効果は観察されなかった（prevalence ratio 0.60、95%CI 0.35-1.02）。 …
- NAID 130007857889
- 遠山 泰崇,古川 雅英,井上 真
- 医療薬学 45(4), 222-227, 2019
- … that is, vasodilation that reduces both preload and afterload, a natriuretic action, and inhibition of the renin-angiotensin-aldosterone system (RASS). … The odds ratio (OR) and 95％ confidence interval (95％ CI) for the occurrence of phlebitis with respect to "the dosing period over 72 hours" were 4.53 (2.07-9.91). …
- NAID 130007830266
Related Links
- Although the aldosterone/renin ratio (ARR) is the most reliable screening test for primary aldo-steronism, false positives and negatives occur. Dietary salt restriction, concomitant malignant or renovascular hypertension, pregnancy and treatment with diuretics (including spironolactone), dihydropyri …
- The aldosterone/renin ratio (ARR) is currently considered the most reliable approach for case detection of primary aldosteronism (PA). ACE (Angiotensin-converting enzyme) inhibitors are known to raise renin and lower aldosterone levels, thereby causing false-negative ARR results.
- In GRA, the aldosterone to renin ratio is elevated (>300), whereas in primary hypertension, AME, and Liddle syndrome, it is not. The biochemical hallmark of GRA is overproduction and excretion of cortisol C-18 oxidation products, reflecting the action of aldosterone synthase on cortisol in the zona fasciculata.
★リンクテーブル★
[★]
- 英
- aldosterone renin ratio, ARR
- 関
- 二次性高血圧、アルドステロン症
- ARR = 血中アルドステロン濃度（PAC）/血漿レニン活性（PRA）
- ARR>200で、PAC>150pg/mLの時に精査を推奨されている。
[★]
- (げっ歯類)ラット、(マウスも含めての総称)ネズミ、ラットの
- 関
- laboratory rat、mouse、Norway rat、Rattus、Rattus norvegicus
[★]
- 関
- fraction、percentage、proportion、rate、specific