HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Stowasser, M. Articles by Gordon, R. D. Search for Related Content PubMed PubMed Citation Articles by Stowasser, M. Articles by Gordon, R. D. Related Collections Endocrinology and Metabolism

Aldosterone Assays: An Urgent Need for Improvement

Endocrine Hypertension, Research Centre, Greenslopes and, Princess Alexandra Hospitals, University of Queensland, Brisbane, Australia.

^aAddress correspondence to this author at: Hypertension Unit, University of Queensland Department of Medicine, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane 4102, Australia; Fax. 61-7-3240-2969; e-mail: m.stowasser@uq.edu.au.

The first 300 words of the full text of this article appear below.

It should not be forgotten that the concentration of aldosterone in plasma is only 1 thousandth that of cortisol. In this issue of Clinical Chemistry, Schirpenbach et al.(1) draw much-needed attention to current problems with measurement of aldosterone. The issue is extremely important in clinical practice after recognition that primary aldosteronism is a much more common cause of hypertension than previously thought(2)(3)(4)(5)(6). Consequently, we have seen a marked increase in screening for this disorder by measuring the ratio of aldosterone to renin (ARR) and by suppression testing to definitively confirm or exclude the diagnosis, both tests that critically depend on reliable aldosterone measurement. Because every hypertensive patient deserves testing to reliably diagnose or exclude this specifically treatable and sometimes curable disorder, the opportunities are tremendous for those marketing commercial aldosterone assay methods (already widely available), and even more so for automated aldosterone assays that offer simplicity, speed, and the opportunity to reduce technician time and/or numbers. Hence, in the midst of a revival in interest in primary aldosteronism and aldosterone measurement, there has been a recent move toward automation of the aldosterone assay, driven primarily by considerations of convenience, cost, or profit. By comparing 2 assay methods and 1 automated method with their more laborious but established in-house assay, which places accuracy and specificity over speed and simplicity, the authors provide a very valuable service(1). Importantly, the commercial assays were found wanting in several critical areas.

Schirpenbach et al. have demonstrated marked differences in mean values among the 4 different assay methods. High "r" values were obtained, but it is of course widely known that correlations between results achieved by 2 methods have little bearing on accuracy. Nevertheless, some authors still place emphasis . . . [Full Text of this Article]

The following articles in journals at HighWire Press have cited this article:

				P. J. Taylor, D. P. Cooper, R. D. Gordon, and M. Stowasser Measurement of Aldosterone in Human Plasma by Semiautomated HPLC-Tandem Mass Spectrometry Clin. Chem., June 1, 2009; 55(6): 1155 - 1162. [Abstract] [Full Text] [PDF]

				N. M. Kaplan and D. A. Calhoun Is There an Unrecognized Epidemic of Primary Aldosteronism? (Con) Hypertension, September 1, 2007; 50(3): 454 - 458. [Full Text] [PDF]

				E. Cavalier, P. Delanaye, J.-M. Krzesinski, and J.-P. Chapelle Analytical Variation in Plasma Renin Activity: Implications for the Screening of Primary Aldosteronism Clin. Chem., April 1, 2007; 53(4): 803 - 804. [Full Text] [PDF]