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    This document provides guidelines for using the aldosterone-renin ratio (ARR) to screen for primary aldosteronism in hypertensive patients. It indicates the patient groups that should receive ARR testing, describes the testing methods, and provides thresholds to interpret the results as positive, negative, or equivocal for primary aldosteronism. Positive results above 830 should be referred to an endocrinology team for further management. The guidelines also note that ARR results should be interpreted in the context of any anti-hypertensive medications the patient may be taking.

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    This document provides guidelines for using the aldosterone-renin ratio (ARR) to screen for primary aldosteronism in hypertensive patients. It indicates the patient groups that should receive ARR testing, describes the testing methods, and provides thresholds to interpret the results as positive, negative, or equivocal for primary aldosteronism. Positive results above 830 should be referred to an endocrinology team for further management. The guidelines also note that ARR results should be interpreted in the context of any anti-hypertensive medications the patient may be taking.

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    20 views2 pages

    Aldosterone Renin Ratio

    Uploaded by

    Poon Canice
    This document provides guidelines for using the aldosterone-renin ratio (ARR) to screen for primary aldosteronism in hypertensive patients. It indicates the patient groups that should receive ARR testing, describes the testing methods, and provides thresholds to interpret the results as positive, negative, or equivocal for primary aldosteronism. Positive results above 830 should be referred to an endocrinology team for further management. The guidelines also note that ARR results should be interpreted in the context of any anti-hypertensive medications the patient may be taking.

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    of 2

    HONG KONG EAST CLUSTER

    Doc. no. HKEC-MED-EN-GL-007-R0

    Effective date 1 Jun 2007


    Last review
    Department of Medicine 1 Nov 2015
    date

    Custodian Endocrine Team


    Aldosterone-renin ratio (ARR)
    Approver COS (MED)

    1. Objective
    To provide guidelines on Aldosterone-renin ratio (ARR)

    2. Indications
    Screening for primary aldosteronism in the following groups of hypertensive patients
    i. Spontaneous hypokalaemia
    ii. Refractory hypertension
    iii. Young hypertensive patients
    iv. Adrenal incidentaloma

    3. Methods
    i. Continue all current anti-hypertensive medications.
    ii. Correct hypokalaemia with potassium supplement.
    iii. Do not need fasting.
    iv. Stop all oral herbs for at least two weeks.
    v. On the day of blood taking, keep upright posture (sit, stand or walk) from 7 am.
    vi. Blood taking between 9 to 10 am in DM centre.

    vii. Fill PYNEH lab form MR2069/PY (白色百搭表格) with 4 additional barcode labels.

    viii. Enter “ ARR; copy to TWEH DM Centre” in Clinical Summary box.


    ix. Enter “ Blood for renin activity and aldosterone” in Test Requested box.
    x. Enter collection date and time.
    xi. Fill blood into 2 purple-cap EDTA and 2 red-cap plain tubes.
    xii. Send blood samples to laboratory immediately under room temperature.

    4. Interpretation
    i. ARR = aldosterone (pmol/L) divided by renin activity (ng · ml-1 · hr-1).
    ii. If renin <0.2, round it to 0.2 for calculation of ARR.
    iii. Positive if ARR > 830; refer endocrine team for further management.
    iv. Negative if ARR < 555.
    v. Equivocal if between 555 and 830.
    vi. Besides the calculated value, ARR result should be interpreted together with the
    potential effects on it by the anti-hypertensive drugs that patients had taken.

    Please refer to intranet for the most updated version Page 1 of 2


    HONG KONG EAST CLUSTER
    Doc. no. HKEC-MED-EN-GL-007-R0

    Effective date 1 Jun 2007


    Last review
    Department of Medicine 1 Nov 2015
    date

    Custodian Endocrine Team


    Aldosterone-renin ratio (ARR)
    Approver COS (MED)

    5. Reference
    1. Stowasser M. The aldosterone-renin ratio in screening for primary aldosteronism.
    The Endocrinologist 2004; 14: 267 – 276

    Please refer to intranet for the most updated version Page 2 of 2

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