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Prorenin and active renin levels in paediatrics: a bioanalytical review

  • Ilja Burdman and Bjoern B. Burckhardt ORCID logo EMAIL logo
Published/Copyright: August 19, 2020
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 59 Issue 2

Abstract

As part of the extended renin-angiotensin-aldosterone system, active renin and its precursor prorenin have been an area of research interest for decades. Although several studies showed a correlation with disease, other studies found no significant association, e.g. attributed to limited sample size or pharmacological effects of antihypertensive drugs. Since the measurement of both proteins has typically been carried out in adult populations, the data in paediatrics is limited. This review aimed to collate the current data on plasma renin and prorenin levels in children and compare the levels of healthy vs. the diseased state. A literature search using Medline resulted in 213 publications of which 15 studies were classified as relevant. In the extant studies in the literature, an age-dependent decline of renin plasma concentration was observed in newborns compared to adolescents. For children with cardiovascular disease, five studies were identified that provide limited insight into the pathophysiological regulation of renin. In general, sample handling is still a crucial step, which might particularly affect measured active renin concentrations due to conformational changes of its precursor prorenin. A reliable assessment for prorenin levels in the maturating population is yet not possible due to the low number of available publications. Three different approaches to quantify prorenin were found and raise the question on the comparability of these methods. The review emphazised several weaknesses and highlights the need for an accurate procedure to determine levels of active renin as well as prorenin in its closed and open form.

Keywords: biomarker; immunoassay; paediatric; prorenin; renin
Corresponding author: Bjoern B. Burckhardt, Heinrich Heine University Düsseldorf - Institute of Clinical Pharmacy, Universitätsstr. 1, Dusseldorf 40225, Germany, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

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Received: 2020-06-05
Accepted: 2020-07-30
Published Online: 2020-08-19
Published in Print: 2021-02-23

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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  2. Editorial
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  4. Review
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  6. Mini Reviews
  7. Negative hair test result after long-term drug use. About a case involving morphine and literature review
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  9. Opinion Paper
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  12. The internal quality control in the traceability era
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https://doi.org/10.1515/cclm-2020-0857
Keywords for this article
biomarker; immunoassay; paediatric; prorenin; renin

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Assuring the quality of examinations using faecal immunochemical tests for haemoglobin (FIT)
  4. Review
  5. Capillary electrophoresis based on nucleic acid analysis for diagnosing inherited diseases
  6. Mini Reviews
  7. Negative hair test result after long-term drug use. About a case involving morphine and literature review
  8. Prorenin and active renin levels in paediatrics: a bioanalytical review
  9. Opinion Paper
  10. From therapeutic drug monitoring to total drug monitoring and drug-omics
  11. Perspectives
  12. The internal quality control in the traceability era
  13. Genetics and Molecular Diagnostics
  14. External quality assessment (EQA) and alternative assessment procedures (AAPs) in molecular diagnostics: findings of an international survey
  15. General Clinical Chemistry and Laboratory Medicine
  16. An evaluation of ten external quality assurance scheme (EQAS) materials for the faecal immunochemical test (FIT) for haemoglobin
  17. Optimizing hepcidin measurement with a proficiency test framework and standardization improvement
  18. Development of a certified reference material for anti-β2-glycoprotein I IgG – commutability studies
  19. Influence of patients’ clinical features at intensive care unit admission on performance of cell cycle arrest biomarkers in predicting acute kidney injury
  20. Efficacy of weekly administration of cholecalciferol on parathyroid hormone in stable kidney-transplanted patients with CKD stage 1–3
  21. Plasma metanephrines and prospective prediction of tumor location, size and mutation type in patients with pheochromocytoma and paraganglioma
  22. Emicizumab, the factor VIII mimetic bi-specific monoclonal antibody and its measurement in plasma
  23. Reference Values and Biological Variations
  24. Age appropriate reference intervals for eight kidney function and injury markers in infants, children and adolescents
  25. Cardiovascular Diseases
  26. Comparison of acetylsalicylic acid and clopidogrel non-responsiveness assessed by light transmittance aggregometry and PFA-100® in patients undergoing neuroendovascular procedures
  27. Trimethylamine-N-oxide (TMAO) predicts short- and long-term mortality and poor neurological outcome in out-of-hospital cardiac arrest patients
  28. Non-lactate strong ion difference and cardiovascular, cancer and all-cause mortality
  29. Infectious Diseases
  30. Performance of three automated SARS-CoV-2 antibody assays and relevance of orthogonal testing algorithms
  31. Development, evaluation, and validation of machine learning models for COVID-19 detection based on routine blood tests
  32. Searching for a role of procalcitonin determination in COVID-19: a study on a selected cohort of hospitalized patients
  33. Association of kidney function with effectiveness of procalcitonin-guided antibiotic treatment: a patient-level meta-analysis from randomized controlled trials
  34. Erratum
  35. Corrigendum to: The role of hyperhomocysteinemia as well as folate, vitamin B6 and B12 deficiencies in osteoporosis – a systematic review
  36. Letter to the Editors
  37. Harmonization of antineutrophil cytoplasmic antibodies (ANCA) testing by reporting test result-specific likelihood ratios: position paper
  38. Independent internal quality control (IQC) for faecal immunochemical tests (FIT) for haemoglobin: use of FIT manufacturers’ IQC for other FIT systems
  39. Parallel testing of 241 clinical nasopharyngeal swabs for the detection of SARS-CoV-2 virus on the Cepheid Xpert Xpress SARS-CoV-2 and the Roche cobas SARS-CoV-2 assays
  40. Sustained SARS-CoV-2 nucleocapsid antibody levels in nonsevere COVID-19: a population-based study
  41. Evidence for increased circulating procoagulant phospholipids in patients with COVID-19 pneumonia and their prognostic role
  42. Complete blood counts and cell population data from Sysmex XN analyser in the detection of SARS-CoV-2 infection
  43. Macro creatine kinase in an asymptomatic patient: a case report
  44. Implementation of pre-labelled barcode tubes and the GeT-System in a general hospital for the exact documentation of the time of venous blood sample and improvement of sample quality
  45. Determination of free light chains: assay-dependent differences in interpretation
  46. Association between SOX17, Wif-1 and RASSF1A promoter methylation status and response to chemotherapy in patients with metastatic gastric cancer
  47. Effect of two organizational interventions on the frequency of haemoglobin A1c and erythrocyte sedimentation rate testing
  48. Haemoglobin A1c determination from dried blood spots prepared with HemaSpot™ blood collection devices: comparison with fresh capillary blood
  49. Stability of catecholamines in whole blood: influence of time between collection and centrifugation
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