Insight into the status of plasma renin and aldosterone measurement: findings from 526 clinical laboratories in China

Weiyan Zhou; Yuhang Deng; Wenjun Ma; Haijian Zhao; Kaijun Wang; Qian Zhang; Wei Gan; Wenxiang Chen; Jun Cai; Chuanbao Zhang

doi:10.1515/cclm-2024-0373

Artikel

Insight into the status of plasma renin and aldosterone measurement: findings from 526 clinical laboratories in China

Weiyan Zhou , Yuhang Deng , Wenjun Ma , Haijian Zhao , Kaijun Wang , Qian Zhang , Wei Gan , Wenxiang Chen , Jun Cai und Chuanbao Zhang

Veröffentlicht/Copyright: 1. Mai 2024

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Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 62 Heft 11

Abstract

Objectives

Accurate measurements of renin and aldosterone levels play an important role in primary aldosteronism screening, which is of great importance in the management and categorization of hypertension. The objective of this study is to investigate the current status of plasma renin and aldosterone measurements in China, which is achieved by analyzing the results of 526 clinical laboratories nationwide for three pooled fresh plasma samples derived from more than 2,000 patients.

Methods

Renin and aldosterone in three pooled plasma samples were measured four times in 526 laboratories employing various measurement systems. The inter- and intra-laboratory %CV were calculated and compared. To determine the source of the substantial inter-laboratory %CV, laboratories were categorized according to the measurement systems they are using, and both the inter- and intra-measurement-system %CV were calculated and compared.

Results

Regarding renin, the majority of laboratories use four primary commercial immunoassays. However, for aldosterone, in addition to commercial immunoassays, laboratory-developed liquid chromatography-tandem mass spectrometry (LC-MS) methods are also used by laboratories. The median values of intra-laboratory %CVs, intra-measurement-system %CVs, inter-laboratory %CVs, and inter-measurement systems %CVs varied between 1.6 and 2.6 %, 4.6 and 14.9 %, 8.3 and 25.7 %, and 10.0 and 34.4 % for renin, respectively. For aldosterone, these values ranged from 1.4 to 2.2 %, 2.5–14.7 %, 9.9–31.0 %, and 10.0–35.5 %, respectively.

Conclusions

The precision within laboratories and measurement systems for plasma renin and aldosterone measurements is satisfactory. However, the comparability between laboratories using different measurement systems remains lacking, indicating the long way to achieve standardization and harmonization for these two analytes.

Keywords: renin; aldosterone; measurement status; primary aldosteronism; hypertension

Corresponding authors: Wenxiang Chen, National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/ National Center of Gerontology, Beijing, P.R. China, E-mail: wxchen@nccl.org.cn; Jun Cai, Beijing Anzhen Hospital, Capital Medical University, Beijing, P.R. China, E-mail: caijun7879@126.com; and Chuanbao Zhang, National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/ National Center of Gerontology, Beijing, P.R. China, E-mail: cbzhang@nccl.org.cn

Weiyan Zhou, Yuhang Deng and Wenjun Ma contributed equally to this work.

Research ethics: This study has been got the permission from the Ethics Committee of Beijing Hospital, with exemption for obtaining informed consent (approval No. 2021BJYYEC-234-02).
Informed consent: Not applicable.
Author contributions: Weiyan Zhou did the experiments, provided the idea, edited and reviewed the manuscript. Yuhang Deng analyzed the data and wrote this manuscript, Wenjun Ma, Qian Zhang, Kaijun Wang, Wei Gan, Haijian Zhao help collect the plasma samples, wenxiang Chen, Jun Cai and Chuanbao Zhang provided the idea of this study. The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: The authors state no conflict of interest.
Research funding: This study is supported by the Capital’s Funds for Health Improvement and Research (2024-2-4059), National High Level Hospital Clinical Research Funding (BJ-2023-094).
Data availability: Not applicable.

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Received: 2024-03-19

Accepted: 2024-04-18

Published Online: 2024-05-01

Published in Print: 2024-10-28

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https://doi.org/10.1515/cclm-2024-0373

Schlagwörter für diesen Artikel

renin; aldosterone; measurement status; primary aldosteronism; hypertension