Feasibility of Screening Primary Aldosteronism by Aldosterone-to-Direct Renin Concentration Ratio Derived from Chemiluminescent Immunoassay Measurement: Diagnostic Accuracy and Cutoff Value

<p><i>Regression curve of </i><svg height="11.927pt" id="M55" style="vertical-align:-3.291101pt" version="1.1" viewbox="-0.0498162 -8.6359 40.395 11.927" width="40.395pt" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"></path></g><g transform="matrix(.013,0,0,-0.013,6.46,0)"><path d="M686 28C612 35 607 44 591 112C563 234 541 360 519 489L489 666L457 658L147 121C100 40 89 36 24 28L17 0H240L250 28C168 34 159 41 190 101L262 237H482C495 180 503 137 510 91C517 47 514 35 441 28L433 0H677L686 28ZM475 280H285L429 541H431L475 280Z"></path></g><g transform="matrix(.013,0,0,-0.013,15.334,0)"><path d="M645 631C614 643 545 666 457 666C215 666 23 519 23 283C23 90 158 -16 337 -16C412 -16 489 2 522 10C543 39 590 127 606 167L580 181C519 89 459 18 348 18C201 18 122 136 122 287C122 464 244 632 435 632C544 632 602 595 608 472L639 475C643 526 645 581 645 631Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,24.114,3.132)"><path d="M636 22C611 29 589 38 560 74C536 104 518 134 495 173L430 300C518 328 592 392 592 492C592 555 563 594 528 618C491 643 435 650 377 650H140L131 618C222 610 223 601 208 518L137 136C121 43 116 40 27 32L18 0H295L300 32C212 40 206 42 223 138L248 279H296C334 279 350 272 369 230C393 174 413 140 441 94C482 24 523 1 626 -8L636 22ZM497 480C497 422 468 374 417 343C387 324 353 315 304 315H255L298 556C303 583 309 598 319 603C331 610 348 613 367 613C448 613 497 573 497 480Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,29.902,3.132)"><path d="M418 650H141L133 618C225 611 232 604 218 531L141 120C126 45 119 37 33 32L24 0H301L308 32C220 37 214 44 227 120L305 531C319 605 325 611 411 618L418 650Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,33.269,3.132)"><path d="M722 32C646 41 636 48 622 116L544 496L509 667L472 658L153 123C106 45 93 42 27 32L18 0H259L268 32C178 40 172 48 204 107L272 233H509C523 180 533 137 540 96C548 50 546 39 466 32L457 0H714L722 32ZM502 283H299L448 547H450L502 283Z"></path></g></svg><i> and </i><svg height="11.927pt" id="M56" style="vertical-align:-3.291101pt" version="1.1" viewbox="-0.0498162 -8.6359 45.5819 11.927" width="45.5819pt" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M600 480C600 590 528 650 384 650H143L137 622C222 614 225 607 210 531L130 127C113 41 106 36 23 28L17 0H294L300 28C204 36 195 42 212 127L243 284L314 263C327 263 339 263 352 264C465 271 600 337 600 480ZM508 481C508 351 402 304 329 304C289 304 265 311 250 317L295 559C302 594 310 606 323 611C335 616 350 619 367 619C455 619 508 573 508 481Z"></path></g><g transform="matrix(.013,0,0,-0.013,6.46,0)"><path d="M686 28C612 35 607 44 591 112C563 234 541 360 519 489L489 666L457 658L147 121C100 40 89 36 24 28L17 0H240L250 28C168 34 159 41 190 101L262 237H482C495 180 503 137 510 91C517 47 514 35 441 28L433 0H677L686 28ZM475 280H285L429 541H431L475 280Z"></path></g><g transform="matrix(.013,0,0,-0.013,15.334,0)"><path d="M645 631C614 643 545 666 457 666C215 666 23 519 23 283C23 90 158 -16 337 -16C412 -16 489 2 522 10C543 39 590 127 606 167L580 181C519 89 459 18 348 18C201 18 122 136 122 287C122 464 244 632 435 632C544 632 602 595 608 472L639 475C643 526 645 581 645 631Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,23.953,3.132)"><path d="M690 629C653 643 577 667 483 667C225 667 24 528 24 292C24 92 174 -17 367 -17C448 -17 534 1 570 10C592 34 642 131 658 174C648 180 639 186 629 192C562 89 499 21 382 21C223 21 130 138 130 298C130 467 255 627 462 627C582 627 643 589 650 462L686 466C689 517 688 580 690 629Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,29.867,3.132)"><path d="M567 167L534 181C505 122 482 94 454 70C428 46 385 42 330 42C288 42 248 44 235 55C216 70 213 91 220 130L295 528C310 609 314 611 401 618L409 650H140L131 618C222 611 224 609 209 528L133 126C118 47 108 41 25 33L18 0H497C514 33 554 126 567 167Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,34.97,3.132)"><path d="M418 650H141L133 618C225 611 232 604 218 531L141 120C126 45 119 37 33 32L24 0H301L308 32C220 37 214 44 227 120L305 531C319 605 325 611 411 618L418 650Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,38.337,3.132)"><path d="M722 32C646 41 636 48 622 116L544 496L509 667L472 658L153 123C106 45 93 42 27 32L18 0H259L268 32C178 40 172 48 204 107L272 233H509C523 180 533 137 540 96C548 50 546 39 466 32L457 0H714L722 32ZM502 283H299L448 547H450L502 283Z"></path></g></svg><i>.</i> Dashed lines: confidence interval; continuous line: regression curve. R<sup>2</sup>=0.6439, Y=0.4431+0.7562×X. <span class="nowrap"><svg height="11.9936pt" id="M57" style="vertical-align:-3.2272pt" version="1.1" viewbox="-0.0498162 -8.7664 39.2533 11.9936" width="39.2533pt" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M46 650V622C120 617 128 613 128 525V125C128 42 120 34 40 28V0H311V28C221 34 212 39 212 124V281L286 262C297 261 316 261 331 263C429 275 526 338 526 468C526 533 501 579 462 609C422 638 364 650 293 650H46ZM212 559C212 588 215 600 223 606C230 613 251 618 279 618C361 618 430 572 430 464C430 337 350 302 285 302C252 302 225 309 212 314V559Z"></path></g><g transform="matrix(.013,0,0,-0.013,6.21,0)"><path d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"></path></g><g transform="matrix(.013,0,0,-0.013,14.828,0)"><path d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,23.566,3.132)"><path d="M639 21C616 28 593 39 566 68C542 92 523 117 486 170C457 215 415 282 397 314C472 346 524 398 524 485C524 545 497 590 456 617C417 641 369 650 296 650H43V617C122 612 130 608 130 523V129C130 45 122 38 38 33V0H306V33C225 38 216 45 216 129V282H249C302 282 319 270 336 243C365 195 401 132 436 84C483 18 525 -5 597 -8C610 -9 622 -9 635 -9L639 21ZM216 319V559C216 586 219 596 227 603S250 613 281 613C356 613 429 576 429 469C429 416 413 379 374 348C349 327 316 319 265 319H216Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,29.381,3.132)"><path d="M308 0V33C225 38 217 44 217 128V521C217 605 225 612 308 617V650H39V617C122 612 130 605 130 521V128C130 44 122 38 39 33V0H308Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,32.201,3.132)"><path d="M682 0V33C615 38 603 49 571 134C507 305 441 494 378 665L343 655L136 136C101 48 86 41 22 33V0H246V33C170 41 161 50 183 112C196 152 209 192 224 232H441C461 176 478 126 493 87C504 49 499 41 433 33V0H682ZM425 279H242C273 363 303 448 335 533H337L425 279Z"></path></g></svg>:</span> plasma aldosterone concentration measured by radioimmunoassay; <span class="nowrap"><svg height="12.0621pt" id="M58" style="vertical-align:-3.2957pt" version="1.1" viewbox="-0.0498162 -8.7664 44.5693 12.0621" width="44.5693pt" xmlns="http://www.w3.org/2000/svg"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M46 650V622C120 617 128 613 128 525V125C128 42 120 34 40 28V0H311V28C221 34 212 39 212 124V281L286 262C297 261 316 261 331 263C429 275 526 338 526 468C526 533 501 579 462 609C422 638 364 650 293 650H46ZM212 559C212 588 215 600 223 606C230 613 251 618 279 618C361 618 430 572 430 464C430 337 350 302 285 302C252 302 225 309 212 314V559Z"></path></g><g transform="matrix(.013,0,0,-0.013,6.21,0)"><path d="M673 0V28C608 34 594 43 563 129C499 303 432 494 370 665L339 656L132 132C98 43 84 37 20 28V0H238V28C162 35 154 45 175 108C188 150 203 192 219 237H432C454 176 474 122 487 83S491 36 428 28V0H673ZM418 280H234C265 362 296 450 328 535H330L418 280Z"></path></g><g transform="matrix(.013,0,0,-0.013,14.828,0)"><path d="M614 175C564 76 510 21 408 21C256 21 146 149 146 336C146 488 235 629 402 629C510 629 570 586 597 480L626 488C620 541 614 582 606 638C578 643 510 665 429 665C206 665 44 527 44 316C44 157 153 -15 402 -15C474 -15 558 5 586 11C604 45 629 119 643 165L614 175Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,23.472,3.132)"><path d="M618 181C565 77 513 26 413 26C264 26 151 150 151 336C151 486 240 625 407 625C516 625 573 582 600 475L634 483C627 540 622 581 613 638C585 643 518 665 435 665C211 665 46 526 46 315C46 158 157 -15 406 -15C480 -15 564 4 594 12C612 43 638 121 651 168L618 181Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,29.597,3.132)"><path d="M499 166C484 119 466 88 447 68C424 43 390 38 338 38C297 38 262 40 242 51C223 62 218 80 218 133V522C218 607 226 612 309 617V650H41V617C124 612 131 605 131 522V129C131 45 123 38 38 33V0H497C505 30 529 128 534 160L499 166Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,34.584,3.132)"><path d="M308 0V33C225 38 217 44 217 128V521C217 605 225 612 308 617V650H39V617C122 612 130 605 130 521V128C130 44 122 38 39 33V0H308Z"></path></g><g transform="matrix(.0091,0,0,-0.0091,37.403,3.132)"><path d="M682 0V33C615 38 603 49 571 134C507 305 441 494 378 665L343 655L136 136C101 48 86 41 22 33V0H246V33C170 41 161 50 183 112C196 152 209 192 224 232H441C461 176 478 126 493 87C504 49 499 41 433 33V0H682ZM425 279H242C273 363 303 448 335 533H337L425 279Z"></path></g></svg>:</span> plasma aldosterone concentration measured by chemiluminescent immunoassay.</p>

International Journal of Hypertension

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Figure 3

Figure 3: Feasibility of Screening Primary Aldosteronism by Aldosterone-to-Direct Renin Concentration Ratio Derived from Chemiluminescent Immunoassay Measurement: Diagnostic Accuracy and Cutoff Value 

Figure 3 | Feasibility of Screening Primary Aldosteronism by Aldosterone-to-Direct Renin Concentration Ratio Derived from Chemiluminescent Immunoassay Measurement: Diagnostic Accuracy and Cutoff Value 