Aldosteron-renin nisbati (ARR)
Kod:10011
| Kabi | Aldosteron Renin |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Immunoanaliz
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
- Restrict carbohydrate intake for 14–30 days before testing.
- Do not consume alcohol for 24 hours prior to the draw.
- Fast for 12 hours before the test; water is allowed.
- When clinically feasible, stop diuretics, antihypertensive drugs, steroids, oral contraceptives, and estrogens for 14–30 days before testing.
- Avoid renin inhibitors for 7 days prior to collection.
- If clinically acceptable, withhold captopril, chlorpropamide, diazoxide, enalapril, guanethidine, hydralazine, lisinopril, minoxidil, nifedipine, nitroprusside, potassium-sparing diuretics (amiloride, spironolactone, triamterene), and thiazide diuretics (bendroflumethiazide, chlorthalidone) for 24 hours before testing.
- If acceptable to the treating clinician, avoid all medications for 24 hours before testing.
- Minimize physical exertion and emotional stress for 72 hours before collection.
- Remain in the planned position (standing or supine) for 60 minutes prior to phlebotomy.
- Do not smoke for 3 hours before testing.
- Schedule collection between 07:00 and 10:00.
Qanday foydalanish
Aldosteron-renin nisbati (ARR), shuningdek aldosteron-renin nisbati nomi bilan ham yuritiladi, birlamchi giperaldosteronizm uchun birinchi bosqichli skriningda qo'llaniladi. Natija avtonom aldosteron ishlab chiqarilishini reninga bog'liq jarayonlardan farqlashga yordam beradi va ikkilamchi gipertenziyaning differensial diagnostikasini qo'llab-quvvatlaydi. ARR testi dori-qarshilikli yoki og'ir gipertenziyani baholashda, gipokaliemiya bilan kechuvchi gipertenziyada va buyrak usti bezining insidentalomasi fonida kuzatiladigan gipertenziyada maqsadga muvofiqdir. Natijalar birlamchi giperaldosteronizm gumon qilinganda keyingi tasdiqlovchi testlar va undan keyingi subtipni aniqlash bo'yicha baholashni yo'naltiradi.
Cheklovlar
Aldosteron bu buyrak usti bezining po'stloq qismida sintez qilinadigan mineralokortikoid bo'lib, natriyni ushlab qolish va kaliyni chiqarib tashlashni ta'minlaydi. Uning sekretsiyasi asosan renin-angiotenzin tizimi tomonidan boshqariladi: buyrak perfuziyasining kamayishi yoki distal naychalarga natriy yetkazib berilishining kamayishi reninni stimulyatsiya qiladi, angiotenzin II hosil bo'ladi va angiotenzin II aldosteron ajralishini qo'zg'atadi. Fiziologik ishlab chiqarish erta tongda cho'qqiga ega va natriy hamda kaliy muvozanati, tana holati, homiladorlik, chekish, jismoniy faollik, stress va renin yoki aldosteronni o'zgartiradigan dorilar bilan farqlanadi. Birlamchi giperaldosteronizm avtonom aldosteron ishlab chiqarilishini aks ettiradi — ko'pincha buyrak usti bezining adenomasi yoki ikki tomonlama giperplaziya tufayli — bu natriyni ushlab qolish, kaliyni yo'qotish va gipertenziyaga olib keladi. Ushbu sharoitda aldosteron-renin nisbati odatda yuqori bo'ladi, chunki aldosteron oshgan, renin esa bosilgan. ARRni to'g'ri talqin qilish standartlashtirilgan yig'ish sharoitlarini va har ikkala gormonga ta'sir qilishi mumkin bo'lgan omillarni, jumladan tana holati, elektrolit holati va dori ta'sirlarini sinchkovlik bilan ko'rib chiqishni talab qiladi.
| O'lchov birligi | ratio | ||||
|---|---|---|---|---|---|
| Referens oraliq |
| ||||
| Ko'rsatmalar | Screening test for suspected primary aldosteronism., Support for the differential diagnosis of secondary forms of hypertension., Workup of resistant or severe hypertension., Evaluation of hypertension with concurrent hypokalemia., Assessment of hypertensive patients who have an adrenal incidentaloma. |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- advanced age
- beta-blockers
- central alpha2-agonists
- chronic kidney disease
- high sodium intake
- hyperkalemia
- nsaids
- pseudohyperaldosteronism
Pasaygan daraja
- ace inhibitors
- angiotensin receptor blockers
- calcium channel blockers (dihydropyridines)
- hypokalemia
- malignant hypertension
- potassium-sparing diuretics
- potassium-wasting diuretics
- pregnancy
- renin inhibitors
- renovascular hypertension
- sodium restriction
Namunangiz talablari
| Namunangiz | Zardob |
|---|---|
| Container | Oltin/yo'lbars qopqoqli probirka (SST, gel ajratgich) |
| Saqlash tayyorlik | Muzda, Sovutilgan, Muzlatilgan |
References
Primary hyperaldosteronism. Clinical guidelines. J Clin Endocrinol Metab. 2008 Jun 13. https://endojournals.ru/index.php/serg/article/download/4016/2186