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Clin Chim Acta. 2009 Dec;410(1-2):90-2. doi: 10.1016/j.cca.2009.09.018. Epub 2009 Sep 18.

Pre-analytical and analytical considerations for the determination of plasma renin activity.

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Department of Nuclear Medicine, University Hospital and University of Bordeaux, France.



Primary hyperaldosteronism diagnosis is helped by assaying renin concentrations either by immunodetection (active renin) or by enzymatic reaction followed by angiotensin I immunoassay (plasma renin activity). We investigated the impact of pre-analytical and analytical conditions on a PRA assay.


PRA was assayed using a commercial kit. Firstly, a retrospective analysis of PRA results from 1yr was performed. Secondly, the impact of pre-analytical temperature conveyance/storage of samples was tested (4 and 25 degrees C). Thirdly, 2 durations of enzymatic reaction 1.5 and 18h were tested.


Retrospectively, 9.5% samples displayed elevated "blanks": calculating PRA with or without "blank" subtraction elicited a difference of >10% in 1/3 samples. There was a significant decrease of PRA values in samples left at 25 degrees C vs 4 degrees C (50% "blank" increase). Finally, the longer the enzymatic reaction (1.5 vs 18h), the higher the production of angiotensin I and the better the PRA assay sensitivity.


We propose a 2 step procedure: a brief 1.5h enzymatic reaction time followed by a prolonged reaction (18h) only if PRA is <0.2ng mL(-1) h(-1). We would recommend performing "blank" samples for the brief enzymatic reaction time. Finally, conveyance/storage temperature does modify PRA results albeit in our hands this had little clinical impact.

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