The factors influencing renin, aldosterone, and the aldosterone-to-renin ratio

This thesis investigates the factors influencing the renin-angiotensin-aldosterone system (RAAS) and their impact on the aldosterone-to-renin ratio (ARR), a key diagnostic tool for detecting primary aldosteronism (PA). The research identifies both controllable and uncontrollable variables that may affect the accuracy of ARR measurements, such as sodium intake, posture, sex hormones, kidney function, circadian rhythms, and medication use. It emphasizes the importance of standardized conditions to minimize diagnostic errors.
The research includes studies that explore these variables. Key findings include the effects of dietary sodium restriction, diurnal variations, age, sex and BMI and a review on various medications that influence the ARR. The results underscore the need for international guidelines based on robust evidence to improve ARR screening reliability. By clarifying confounding factors, this thesis contributes to more accurate diagnosis and treatment of PA, enhancing patient outcomes.