Angiotensin I (Plasma Renin activity) ELISA
- Regulatorischer Status
- EU: CE
- Kit Größe
- 96
- Methode
- ELISA
- Inkubationszeit
- 1 x 1h, 1 x 30min, 1 x 15min
- Standardbereich
- 0.2 - 60 ng/mL
- Probe / Vorbehandlung
- 500 µL EDTA Pasma
- Substrat / Isotop
- TMB 450 nm
For the quantitative measurement Plasma Renin Activity (PRA) in human EDTA plasma by an ELISA (Enzyme-Linked Immunosorbent Assay). This kit is intended for professional use only and is for laboratory use only. For in vitro diagnostic use only. Intended to be used manually but may be adaptable to open automated analyzers. The user is responsible for validating the performance of this kit with any automated analyzers.
Plasma renin activity is an important diagnostic test for individualized therapy for resistant hypertension. It has been reported that measuring plasma renin activity significantly improved blood pressure control in patients with severe resistant hypertension.[1] A randomized trial in the USA reported a reduction of medication required to achieve control using plasma renin activity to guide therapy.[2]
PRA is based on renin releasing angiotensin-I from angiotensinogen. Angiotensin-I is transformed to angiotensin-II largely in pulmonary circulation by the angiotensin-converting enzyme (ACE). Angiotensin-II raises blood pressure by direct arteriolar vasoconstriction, promoting sodium retention, and stimulating the secretion of aldosterone from the adrenal cortex. Aldosterone also exerts an effect to restore sodium balance and lift arterial pressure. Hence, the determination of plasma renin activity can aid in the diagnosis of primary hyperaldosteronism (5 - 13% of hypertensive cases) and assist in the therapy and management of other forms of hypertension.
PRA and renin concentration assays provide different information about plasma renin. First, PRA is the expression of the rate of angiotensin-I formation through the enzymatic action of renin on its substrate, angiotensinogen. Therefore, PRA depends not only on renin concentration but also on the concentration of angiotensinogen which is overlooked in the renin concentration assays. Second, plasma renin concentration assays do not ensure sensitivity in low renin states, while the sensitivity of the PRA assay can be enhanced by increasing the incubation time during the generation step. Third, PRA is influenced by inhibitors, whereas the presence of inhibitors does not affect the recognition of renin by currently available immunoassays, therefore total renin concentration does not always correlate with plasma renin activity. Those differences should be understood by clinicians and clinical chemists for the correct interpretation of the assays.[17]
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[1] Spence JD. (1999) Physiologic tailoring of therapy for resistant hypertension: 20 years' experience with stimulated renin profiling. Am J Hypertension. 12(11 Pt 1):1077-83.
[2] Egan BM, Basile JN, Rehman SU, Davis PB, Grob CH, III, Riehle JF, et al. (2009) Plasma Renin test-guided drug treatment algorithm for correcting patients with treated but uncontrolled hypertension: a randomized controlled trial. Am J Hypertens. 22(7):792-801.
[3] Tan ACITL, Kloppenborg PWC, Benraad TJ. (1989) Influence of Age, Posture and Intra-Individual Variation on Plasma Levels of Atrial Natriuretic Peptide. Annals of Clinical Biochemistry. 26(6):481-486.
[4] Tiu, S. C., Choi, C. H., Shek, C. C., Ng, Y. W., Chan, F. K., Ng, C. M., & Kong, A. P. (2005). The use of aldosterone-renin ratio as a diagnostic test for primary hyperaldosteronism and its test characteristics under different conditions of blood sampling. The Journal of clinical endocrinology and metabolism, 90(1), 72–78..
[5] Sealey JE, Gerten-Banes J, Laragh JH (1972), The renin system: Variations in man measured by radioimmunoassay or bioassay Kidney International 1:240-253.
[6] Sealey, J. E., Gordon, R. D., & Mantero, F. (2005). Plasma renin and aldosterone measurements in low renin hypertensive states. Trends in endocrinology and metabolism. TEM, 16(3), 86–91.
[7] J. Brossaud and J.B. Corcuff, (2009) Pre-analytical and Analytical Considerations for the Determination of Plasma Renin Activity, Clinica Chimica Acta 410:90–92.
[8] F. K. Suessenbach, B. B. Burckhardt. Levels of angiotensin peptides in healthy and cardiovascular/ renal - diseased paediatric population—an investigative review. Heart Failure Reviews (2019) 24:709–723
[9] https://doi.org/10.1007/s10741-019-09797-y
[10] Guoqing Yao, Wenjing Li, Wenzhao Liu, et al. (2021) The Level and Significance of Circulating Angiotensin-III in Patients with Coronary Atherosclerosis. Hindawi Journal of the Renin-Angiotensin-Aldosterone System. 1704762,
[11] Valle Martins AL, da Silva FA, Bolais-Ramos L, et al. (2021) Increased circulating levels of angiotensin-(1–7) in severely ill COVID-19 patients. ERJ Open Res 7: 00114-2021 [DOI: 10.1183/23120541.00114-2021].
[12] Clare A. McKinney, Caroline FATTAH, Christopher M. Loughrey et al. (2014) Angiotensin-(1–7) and angiotensin-(1–9): function in cardiac and vascular remodelling. Clinical Science. 126, 815–827 (Printed in Great Britain) doi: 10.1042/CS20130436
[13] Stirati G, de Martino A, Mene P, et al. (1983) Plasma renin activity: effect of temperature during blood processing. J Clin Chem Clin Biochem 529-31
[14] Ruth Lapworth, Sally E Green and Frances Short. (1990) In vitro stability of assayed renin activity in plasma and whole blood. Ann Clin Biochem 27: 78-79
[15] Zoltan Locsei, Karoly Racz, Attila Patocs et al. (2009). Influence of sampling and storage conditions on plasma renin activity and plasma renin concentration. Clinica Chimica Acta 402 203–205
[16] Morganti, A; Lonati, C; Turolo, L (2010) Brief Cryoactivation Markedly Affects Plasma Renin Activity and Direct Renin Measurement in Low Renin Samples: PP.24.473, Journal of Hypertension: 28 p e388 doi: 10.1097/01.hjh.0000379399.50039.3c.
[17] Sealey JE. (1991) Plasma renin activity and plasma prorenin assays. Clin Chem. 37(10 Pt 2):1811-9. PMID: 1914195.
[18] Campbell, D. J., Nussberger, J., Stowasser, M., Danser, A. H., Morganti, A., Frandsen, E., & Ménard, J. (2009). Activity assays and immunoassays for plasma Renin and prorenin: information provided and precautions necessary for accurate measurement. Clinical chemistry, 55(5), 867–877.
[19] Brossaud J, Corcuff JB. Pre-Analytical and Analytical Considerations for the Determination of Plasma Renin Activity. Clin Chim Acta. 2009; 410(1–2):90–2.
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