LABOKLIN Service ID: 497
Renin-angiotensin-aldosterone system status
| Diagnosis | Differentiated analysis of disorders of blood pressure and electrolyte
regulation:- differentiation between primary and secondary hyperaldosteronism
- cardiac and renal diseases
- systemic hypertension
- monitoring of pharmacological RAAS blockades (ACE inhibitors, ARBs (angiotensin receptor blockers), MRAs (mineralocorticoid
receptor antagonists))
|
| Material | Serum 1ml (centrifuged and separated shortly after coagulation, pipetted off; frozen until arrival at the laboratory – please contact the laboratory for transport options in advance) |
| Parameter | Renin activity, angiotensin I+II concentration and aldosterone concentration (quantitative) |
| Method | Liquid chromatography-mass spectrometry (LCMS) |
| Species list | Dog, cat |
| Duration | 3–6 working days |
| Assessment | Angiotensin I (Ang I)
↑ Ang I = increased renin release (volume deficiency, Na deficiency, heart failure, medication)
↓ Ang I = decreased renin release (hypervolaemia, primary hyperaldosteronism)
Angiotensin II (Ang II)
↑ Ang II = increased ACE activity or RAAS activation
↓ Ang II = successful ACE blockade, e.g. after administration of enalapril, or low activation of the renin-angiotensin-aldosterone system (e.g. in primary hyperaldosteronism)
Aldosterone
↑ Aldosterone while ↓ Ang II → Aldosterone escape = autonomous, ACE-independent aldosterone production
↑ Aldosterone while ↑ Ang II → classic RAAS activation
↓ Aldosterone → suppressed RAAS axis or hypokalaemia
Renin activity (PRA-S) – indirectly determined via Ang I + Ang II
↑ PRA-S = renin release through negative feedback (e.g. after administration of ACE inhibitors, volume deficiency)
↓ PRA-S = renin suppression (volume overload, hypertension, high sodium intake, primary hyperaldosteronism)
ACE activity (ACE-S) – determined by the Ang II/Ang I ratio
↑ ACE-S = high conversion of Ang I → Ang II → active RAAS
↓ ACE-S = functional inhibition of ACE, e.g. after administration of enalapril, or low Ang II production
AA2 ratio (aldosterone/Ang II) – the most important marker for functional examination
low AA2: aldosterone proportional to Ang II → classic axis intact
high AA2: aldosterone disproportionately high despite low Ang II → Ang II-independent aldosterone production (primary hyperaldosteronism) |
| Remark | Note: The sample must arrive frozen at the laboratory. Please contact laboratory for transport options. |
