Alison Woodworth and Joesph Wiencek - Advances in the Diagnosis of Primary Aldosteronism

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Primary Aldosteronism (PA) is a group of disorders characterized by inappropriate aldosterone production. PA is commonly caused by an adrenal adenoma, or by hyperplasia of the adrenal zona glomerulosa that can be either unilateral or bilateral. The disorder accounts for up to 15% of total hypertensive patients making it a serious public health concern. Patients with PA have a higher cardiovascular morbidity and mortality risk when compared with those with essential hypertension matched for age, sex and blood pressure. Fortunately, timely diagnosis through laboratory testing leads to a potentially treatable or curable disorder. The Endocrine Society guidelines recommend a multi-tiered approach with both screening and provocative confirmatory testing for the diagnosis of PA. The guidelines recommend the plasma aldosterone/plasma renin ratio (ARR) as the most reliable screening test for PA. Traditionally, renin is measured by a plasma renin activity (PRA) radioimmunoassay or liquid chromatography tandem mass spectrometry (LC-MS/MS). However, newer quantitative renin mass immunoassays offer benefits of walk-away automation, better turnaround times and stability with comparable diagnostic accuracy to PRA. In this webinar, we will discuss the updates to the Endocrine Society practice guidelines for the management of PA and present data from a large study assessing the diagnostic accuracy of different Renin assays to predict PA in hypertensive patients.