Endocrine Laboratory, Department of Laboratory Medicine, Amsterdam UMC location University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Amsterdam Gastroenterology, Endocrinology & Metabolism, 1105 AZ Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 2024 May 17;109(6):e1472-e1475. doi: 10.1210/clinem/dgae057.
Cryoactivation is known to occur in whole blood and plasma samples when kept between +4 and -5 °C, leading to falsely high renin concentrations. In 2022 it has been clearly shown that cryoactivation can also occur in samples stored at -20 °C. Based on these new findings, here we discuss how this can influence the clinical diagnosis of patients. First, we show that storage of renin plasma samples can affect the renin measurements and thereby the aldosterone to renin ratio (ARR) calculation, which might explain the high intraindividual variability in ARR also recently demonstrated. Second, we discuss the existing studies on the establishment of renin reference intervals and note the lack of attention given to this recently revealed preanalytical condition. Our literature review of the reference intervals for renin suggest that cryoactivation might have influenced the published data.
低温激活已知会在全血和血浆样本中发生，当样本保存在+4 到-5°C 之间时，会导致肾素浓度假性升高。2022 年已经清楚地表明，低温激活也可能发生在储存在-20°C 的样本中。基于这些新发现，我们在这里讨论它如何影响患者的临床诊断。首先，我们表明肾素血浆样本的储存会影响肾素测量，从而影响醛固酮与肾素比值（ARR）的计算，这可能解释了最近也证明的 ARR 的高个体内变异性。其次，我们讨论了现有的肾素参考区间建立研究，并指出对最近发现的这种分析前条件缺乏关注。我们对肾素参考区间的文献回顾表明，低温激活可能影响了已发表的数据。
