Abstract

 
 
 
 Purpose: To compare the diagnostic accuracy of plasma aldosterone concentration (PAC), plasma renin activity (PRA) and aldosterone-to-renin ratio (ARR) in primary aldosteronism (PA) using radioimmunoassay (RIA) and chemiluminescence immunoassay (CLIA) methods.
 Methods: Both RIA and CLIA were used to analyze the PAC, PRA and ARR with subjects in standing or supine position, before and after a saline infusion test (SIT). The correlation between RIA and CLIA was measured by regression analysis. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy by RIA and CLIA.
 Results: A positive correlation was found between PAC and PRA after SIT using RIA and CLIA (0.1745 and 0.3085, respectively). A positive correlation was found between the PAC and PRA in standing and supine position using RIA and CLIA (0.3979 vs 0.2399 and 0.1885 vs 0.4032, respectively). There was no obvious difference in AUCs of PAC, PRA, and ARR between RIA and CLIA (PAC: 0.91 vs. 0.89; PRA: 0.88 vs. 0.87; ARR: 0.93 vs. 0.92). In standing posture, the AUCs of PAC, PRA and ARR using RIA were 0.63, 0.72 and 0.78, respectively, and the results of CLIA were 0.65, 0.75 and 0.82, respectively. In supine posture, the AUC of PAC, PRA and ARR using RIA was 0.65, 0.68 and 0.71, respectively, and the results of CLIA were 0.68, 0.70 and 0.79, respectively.
 Conclusion: Chemiluminescent assay is reliable for diagnosis of PA when compared with radioimmunoassay.
 
 
 
Highlights
Primary aldosteronism (PA) is a syndrome caused by either an adrenal mass or bilateral hyperplasia of the adrenals
There were no significant differences in age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), and serum potassium between PA and non-PA patients
A, a positive correlation was found between the plasma aldosterone concentration (PAC) and plasma renin activity (PRA) before and after suppression test (SIT) using RIA and chemiluminescence immunoassay (CLIA) (before SIT: PAC by RIA vs. PAC by CLIA (R2 = 0.1316, p < 0.0001; PRA by RIA vs. PRA by CLIA (R2 = 0.4156, p < 0.0001); after SIT: PAC by RIA vs. PAC by CLIA, (R2 = 0.1745, p < 0.0001); PRA by RIA vs. PRA by CLIA (R2 = 0.3085, p < 0.0001). These results suggested that there was no significant difference between RIA and CLIA to detect PAC and PRA
Summary
Primary aldosteronism (PA) is a syndrome caused by either an adrenal mass or bilateral hyperplasia of the adrenals. The present study aimed to compare the diagnostic accuracy of PAC, PRA and ARR using CLIA and RIA methods. According to the guideline of Endocrine Society Clinical Practice, when the level of postinfusion plasma aldosterone is
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