DO NOT STORE OR TRANSPORT AT 4
o
C
(cryoactivation of prorenin occurs at 4
o
C and may lead to a falsely elevated result for renin)
To avoid refrigeration of the sample, it is preferable to not share EDTA samples with Haematology requests.
Units: mU/L
|
Paediatric: < 1 week |
0 - 790 |
|
1 week - 1 year |
7 - 180 |
|
1 - 15 years |
9 - 134 |
|
15 - 18 years >18 years |
9 - 60 4 - 46 |
|
Adult: |
4 - 46 (sitting) 3 - 40 (supine for 1 hour) |
- The above figures are for average salt intake. At low salt intakes renin levels are increased.
- Antihypertensive drugs: Diuretics, ACE inhibitors, ARBs, and vasodilators tend to increase renin levels.
- Beta blockers, clonidine, aldomet, and NSAIDs tend to decrease renin levels.
- Women using oral contraceptives have lower levels (about half normal).
- Pregnant women have higher levels (about double normal).
- High renin levels are seen in heart failure and cirrhosis.
Uncertainty of Measurement:
15%
Performed Weekly.
Principle: Sandwich chemiluminescent immunoassay
Assay: Diasorin
Analyser: Diasorin Liaison
Renin and Aldosterone in Hypertension:
The interpretive guide below applies only to patients with hypertension without heart failure, and does not apply to a saline suppression test.
Renin
Aldosterone
Interpretation
>60
>60
0-1000
>1000
Compatible with ACE inhibitor or angiotensin receptor blocker therapy, high renin essential hypertension, or renovascular hypertension.
Suggests secondary hyperaldosteronism. Causes include renovascular disease, malignant hypertension, diuretics, spironolactone
<10
>400
Suggestive of primary aldosteronism. A saline suppression test can be done to confirm this. This can be arranged with the Dept. of Endocrinology.
<10
<400
Low-renin, low aldosterone hypertension. Likely to be salt-sensitive and to respond well to diuretic therapy and salt restriction. Consider Liddle's syndrome if hypokalemia is present.
10-60
0-1000
Compatible with essential hypertension.
10-60
>1000
Hyperaldosteronism is present; it is unclear from the renin level whether this is primary or secondary.
Primary Aldosteronism:
Plasma renin is typically suppressed to less than 10 mU/L in Conn's syndrome, even in the presence of upright posture, diuretics or ACE inhibitor drugs.
At the same time, the plasma aldosterone is typically greater than 600 pmol/L and the aldosterone/renin ratio > 55.
Hyperreninemia:
ACEIs, ARBs, diuretics, and aldosterone antagonists can increase renin up to levels of 300 mU/L.
Renovascular disease:
Very high renin levels (>300) suggest renovascular disease. In young patients the cause may be fibromuscular dysplasia, and in older patients it is more likely to be due to atherosclerosis.
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427
| Sample |
5 mL EDTA 1 mL Paediatric EDTA |
| Sample Preparation |
DO NOT refrigerate or chill in any way |
| Transport to LabPlus |
DO NOT refrigerate or chill in any way |