Mitchell J R, Taylor A A, Pool J L, Lake C R, Rollins D E, Bartter F C
Ann Intern Med. 1977 Nov;87(5):596-312. doi: 10.7326/0003-4819-87-5-596.
Renin-aldosterone profiling was used to classify patients with hypertension: 243 patients with essential hypertension were classified by renin-urinary sodium indexing; 107 were reclassified by response to administration of furosemide and intravenous saline; 45 were further classified by response to a low-sodium diet. Arbitrary "normal ranges" were determined in 89, 32, and 38 volunteers, respectively. Patients with low-renin apparently do not have "high-volume" hypertension. Rather, they show a primary renal abnormality in renin secretion and become relatively deficient in angiotensin II and aldosterone when they are subjected to diuresis. They can maintain aldosterone secretion under normal conditions because their adrenal aldosterone receptor is supersensitive to angiotensin II. No evidence of abnormal sympathetic neural activity was found among the renin subgroups. Renin-aldosterone profiling in current clinical practice seems useful mainly in the detection of patients with curable forms of secondary hypertension. Aldosterone/renin ratios may be particularly helpful in diagnosis when obtained after a patient has undergone expansion or contraction of his extracellular fluid volume.
肾素-醛固酮分析用于对高血压患者进行分类：243例原发性高血压患者通过肾素-尿钠指数进行分类；107例通过对呋塞米和静脉注射生理盐水的反应重新分类；45例通过对低钠饮食的反应进一步分类。分别在89名、32名和38名志愿者中确定了任意的“正常范围”。低肾素患者显然没有“高血容量”性高血压。相反，他们表现出肾素分泌的原发性肾脏异常，在进行利尿时，血管紧张素II和醛固酮相对缺乏。他们在正常情况下可以维持醛固酮分泌，因为其肾上腺醛固酮受体对血管紧张素II超敏感。在肾素亚组中未发现异常交感神经活动的证据。目前临床实践中的肾素-醛固酮分析似乎主要有助于检测可治愈的继发性高血压患者。当在患者经历细胞外液容量扩张或收缩后获得醛固酮/肾素比值时，可能对诊断特别有帮助。
