National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China.
National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing Engineering Research Center of Laboratory Medicine, Beijing, China.
J Clin Lab Anal. 2022 Nov;36(11):e24738. doi: 10.1002/jcla.24738. Epub 2022 Oct 25.
Plasma renin activity (PRA) is one of the recommended screening indicators for primary aldosteronism (PA) diagnosis and had become increasingly important in hypertension identification, medication guidance, and endocrine disorder confirmation.
To provide an overview of the PRA measurement progress and clinical value, this review summarizes the main contributing factors related to PRA measurement and necessary precautions during the entire analysis process. We also outline the characteristics of PRA in different endocrine diseases and their clinical utility.
Significant inconsistency was observed in PRA measurement methods, including immunoassay and isotope dilution liquid chromatography-tandem mass spectrometry (ID-LC/MS/MS), which could be attributed to preanalytical, analytical, and postanalytical variations. Meanwhile, consensus about environmental and procedural factors during the entire analytical process, including storage temperature, incubation condition, blank subtraction, and standardized operational procedures across different self-developed assay laboratories, could be important to minimize analytical variations. Furthermore, commutable uniform calibrators should be prepared to improve consistency, ultimately achieving accurate and reliable measurement of PRA.
This review summarizes the clinical utilization of PRA as a biomarker in multiple diseases, elaborating on routine detection methods and the key factors in the analytical process. We also provide feasible strategies for improving standardization and facilitating PRA assessment for larger-scale clinical applications.
血浆肾素活性（PRA）是原发性醛固酮增多症（PA）诊断的推荐筛查指标之一，在高血压鉴别、药物指导和内分泌紊乱确认方面的作用日益重要。
为了全面了解 PRA 测量的进展和临床价值，本综述总结了与 PRA 测量相关的主要影响因素以及整个分析过程中的必要注意事项。我们还概述了不同内分泌疾病中 PRA 的特点及其临床应用。
PRA 测量方法存在显著的不一致性，包括免疫测定和同位素质谱稀释液相色谱-串联质谱法（ID-LC/MS/MS），这可能归因于分析前、分析中和分析后变化。同时，在整个分析过程中，对于环境和程序因素达成共识，包括储存温度、孵育条件、空白扣除和不同自建检测实验室的标准化操作程序，对于最小化分析变化非常重要。此外，应制备可互换的统一校准品以提高一致性，最终实现 PRA 的准确可靠测量。
本综述总结了 PRA 作为多种疾病生物标志物的临床应用，详细介绍了常规检测方法和分析过程中的关键因素。我们还提供了可行的策略来改善标准化，为更大规模的临床应用提供 PRA 评估。
