• 핵의학기술
• /
• 제22권1호
• /
• pp.84-89
• /
• 2018

Purpose Renin is a proteolytic enzyme synthesized and secreted from epidermal(juxtaglomerular) cells in kidney. Renin acts on the renin substrate angiotensinogen to produce angiotensin I, and then angiotensin II is produced by the action of angiotensin converting enzyme. This causes the adrenal glands to boost blood pressure (vasoconstriction) and promote aldosterone secretion. While Plasma renin activity (PRA) is to test angiotensin I, the active renin concentration (ARC) is a renin test directly. They have different test methods and their own substrates. However, these two methods are sometimes interpreted as the same as a result. The purpose of this study was to evaluate the usefulness of the ARC test by comparing the results between PRA and ARC. Materials and Methods For the diversity of the experiment, 26 samples were requested to test with PRA(TFB company) and ARC(Cisbio company) to other institution. We compared and analyzed PRA(Immunotech company) and ARC(Cisbio company) tests using 28 samples from September $15^{th}$ to October $13^{th}$ in 2017. The statistical analysis method for PRA/ARC evaluated the usefulness using Microsoft Excel program by verifying a correlation analysis of Aldosterone/PRA ratio and a correlation analysis of Aldosterone/ARC ratio and conducting T-test. Results The regression equation of the PRA(Immunotech company)/ARC(Cisbio company), which was tested in the department, was y = 0.0619x + 0.4615 and the correlation coefficient was 0.73. The regression equation of the PRA(TFB company)/ARC(Cisbio company), which was tested in the other institution, was y = 0.0888x + 0.3316 and the correlation coefficient was 0.91. In addition, The regression equation of Aldosterone / PRA ratio and Aldosterone / ARC ratio was y = 0.875x - 11.688 and the correlation coefficient was 0.87. Plus T - test showed no significant difference (P>0.05). Conclusion Both tests showed a strong positive correlation, but this only represents the strength and direction of the relationship between the two tests. Furthermore, the actual results showed somewhat differences. It is presumed that the measured value was influenced by the endogenous renin group mass in the plasma, the condition of the enzyme reaction and the kind of the inhibitor. When the active renin concentration (ARC) test is performed, it is useful to distinguish between the two tests as they are complementary.

• 대한핵의학회지
• /
• 제9권1호
• /
• pp.21-29
• /
• 1975

Radioimmunoassay for the measurement of plasma renin activity (PRA) was performed in 43 normal Koreans and 45 patients with essential hypertension. Plasma samples were drawn in supine position in the morning and after upright posture for 4 hours. Urinary sodium excretion rates were measured in the concurrent 24 hour urine samples, as an index of their sodium balance. The results were as follows: 1. There was an inverse correlation between 24hr sodium excretion and PRA. The normal values of PRA in supine position ranged from 1.0 to 7.0 ng/ml/hr. when 24 hour sodium excretion were between 50 to 150 mEq. PRA in elderly tended to be low. 2. When stimulated by 4 hour upright posture, PRA increased by 2.6 times from the baseline value. 3. Of the 45 patients with essential hypertension, PRA was low in 10 cases (22.2%), normal in 28 cases (62.2%), and high in 7 cases (15.6%). 4. In the normal and high renin groups, who tended to be younger in ages, mean diastolic blood pressure and BUN were higher than in low renin group. Though hypertensive retinopathy and left ventricular hypertrophy in ECG were more prevalent in the former, no significant differences were noted as in the case of serum cholesterol. 5. There were 8 cases of cardiovascular complications (7 with cerebral vascular accident, 1 with myocardial infarction); 3 in low renin group (30%), 2 in normal renin (7.1%) and 3 in high renin group (42.9%). This figure indicated higher rate of cardiovascular complications in high renin groups, and lower rate in normal renin group. But the incidence of the complication was not significantly low in low renin group.

• Journal of Preventive Medicine and Public Health
• /
• 제24권4호
• /
• pp.516-530
• /
• 1991

일상생활을 통한 연섭취로 인한 고혈압 발생 가능성 및 이때 연이 혈압에 영향을 미칠 수 있는 기전을 밝히기 위한 연구의 일환으로 환자 대조군 연구를 실시하였다. 대상자로서 울산 및 그 인근지역의 직업적 연폭로 과거력이 없는 남자 근로자 중 고혈압 환자 72명, 대조군 69명을 선택하였다. 혈중 연과 혈장레닌활성도(Plasma renin activity, PRA)를 측정하였으며 동시에 흡연유무, 음주유무, 고혈압 가족력 유무를 확인하고 body mass index(BMI), 혈청 소디움, 포타시움, 이온화 칼슘, 크레아티닌 및 총 콜레스테롤을 측정하였다. 고혈압군의 혈중 연농도는 $19.8{\pm}5.5{\mu}g/dl$로서 대조군의 $12.5{\pm}4.7{\mu}g/dl$에 비해 유의하게 높았고(p<0.01) 또한 혈중 연의 고혈압발생에 대한 교차비(odds ratio)가 1.38로서 역시 유의하였다(p<0.01). PRA나 In(PRA)가 고혈압군과 대조군 사이에 유의한 차이가 없었으나 고혈압군에서 혈중 연농도가 증가함에 따라 PRA도 어느정도 증가하는 양상을 보였고(p<0.1), In(PHA)를 종속변수로 하는 중회귀분석을 실시하였을 때 혈중 연농도(회귀계수 ; 0.037)가 10% 수준에서 유의하였다. 본 연구를 통해 볼 때, 지금까지 알려진 정상치 범위 이내의 혈중 연과 고혈압 발생간의 인과 관계에 대해 계속 연구해 볼 필요성을 느끼며 이때 PRA의 변화가 작용 기전의 일부에 관여할 가능성이 있을 것으로 추측된다.

• 핵의학기술
• /
• 제25권1호
• /
• pp.29-33
• /
• 2021

PRA 검사는 치료 가능한 고혈압 질환 중 하나인 일차성 알도스테론증의 선별 진단에 이용되는 검사 중 하나이다. 혈장의 레닌은 체외에서 변형이 쉬운 물질이며 온도 변화에 민감한 것으로 알려져 있다. 본 연구에서는 검체의 보관온도와 해동온도에 차이를 두어 각각의 결과 차이를 비교 분석하고, PRA 검사의 정확한 결과 보고를 위한 치침의 마련과 재현성을 높일 수 있는 방안을 마련하고자 하였다. 본원에 의뢰된 PRA 검체 43건에 대하여 냉동보관 혈장 분리 자검체와 냉장보관 EDTA tube의 혈장을 재검사 실시하였다. 본검사를 기준으로 회귀분석과 bland-altman plot, 백분율을 비교하여 결과를 분석하였다. 또한, 해동온도에 따른 결과 비교를 위하여 PRA 검체 13건에 대하여 각각 실온해동과 냉장해동을 실시하였다. 실험을 마친 뒤, 다시 얼리고 2차 실온해동과 냉장해동을 실시하여 본검사를 기준으로 결과를 회귀분석하였다. 혈장 분리된 자검체 재검사를 시행한 결과는 y = 1.2048x + 1.046(R=0.8501, n=43)이며, 냉장보관 EDTA tube의 혈장으로 재검사한 결과는 y = 1.0594x + 0.1365 (R=0.9966, n=41)였다. Bland-altman plot에서 본실험과 차이에 대한 평균이 EDTA tube 혈장 재검사한 결과가 0.24, 냉동보관 자검체 재검사한 결과가 1.4로 냉장 보관 EDTA tube의 혈장이 높은 상관관계를 나타내었다. 해동온도에 차이를 두고 비교실험 한 결과, 1차 실온해동한 결과보다 2차 실온해동한 결과의 평균 백분율이 증가한 것으로 나타났다. 동일하게, 1차 냉장해동 결과보다 2차 냉장해동 결과의 평균 백분율이 증가하였다. 본 연구를 통해 PRA 검체의 보관 방법과 해동 온도에 따른 결과변화를 비교 분석한 결과, 냉장 보관된 원검체 EDTA tube 혈장의 재검사 결과가 더 높은 상관관계를 나타내었다. 또한, 해동 시 온도에 상관없이 혈장분리 자검체의 반복적인 얼림과 녹임이 PRA 결과에 영향을 미치는 것으로 나타났다. 따라서 PRA의 재검사 시에는 냉장 보관 중인 원검체 EDTA tube에서 혈장을 다시 채취하여 검사하는 것이 검사 결과의 오차를 줄이고 재현성을 높일 수 있을 것으로 사료된다.

• 대한핵의학회지
• /
• 제10권1호
• /
• pp.35-46
• /
• 1976

To evaluate the possible pathophysiologic role of renin in acute renal failure observed in Korean hemorrhagic fever (KHF), the author measured the basal plasma renin activity (PRA) and the stimulated PRA by radioimmunoassay for angiotensin I in 15 normal controls and 42 KHF patients who are admitted in Seoul National University Hospital and Nation Army Hospital from Jan. 1975 to Jan. 1976. The results obtained were as follows: The mean basal PRA in normal control group was $2.9{\pm}2.16ng/ml/hr$ in the patients during the oliguric phase of KHF, the mean basal PRA was $4.7{\pm}2.13ng/ml/hr$, and there was statistically significant increase compared to the normal control. In the patients during the diuretic phase of KHF, the mean basal PRA was $3.4{\pm}2.09ng/ml/hr$, and there was statistically significant decrease compared to the oliguric phase of KHF. In normal control group, the mean basal PRA was $2.9{\pm}2.16ng/ml/hr$. And the PRA 1 hour after the administration of $Lasix^{(R)}$ 40 mg intravenously(stmulated PRA) was $5.3{\pm}2.20ng/ml/hr$ and there was statistically significant increasec ompared to basal level. In oliguric phase of KHF, the mean basal PRA was $4.6{\pm}2.01ng/ml/hr$. And stimulated PRA was $4.4{\pm}2.34ng/ml/hr$ and there was no significant changes. In diuretic phase of KHF, the mean basal PRA was $3.3{\pm}1.86ng/ml/hr$. And stimulated PRA was 5.2{\pm}2.58ng/ml/hr and there was statistically significant increase compared to basal level. There were statistically no significant correlations between basal PRA and stimulated PRA and serum creatinine, BUN, urine volume and peritonial dialysis.

• 대한핵의학회지
• /
• 제12권1호
• /
• pp.9-16
• /
• 1978

It has been suggested that plasma renin activity (PRA) and its response to volume depletion may be abnormal in that it shows little or exaggerated change in patients with chronic renal failure and hypertension. Intravenous furosemide stimulation test was performed in 46 control subjects and 51 patients with chronic renal failure and/or malignant hypertension in order to evaluate PRA response. In contrast to the consistent increase in PRA in control subjects (from $2.5{\pm}1.95\;to\;4.5{\pm}2.51ng/ml/hr$), no consistent increase was observed in patients with chronic renal failure, especially in those who showed favorable response to antihypertensive therapy (from $2.5{\pm}2.21\;to\;2.9{\pm}2.46ng/ml/hr$). But poor responder to antihypertensive treatment showed considerably higher PRA before and after furosemide stimulation (from $4.9{\pm}1.96\;to\;6.4{\pm}1.71ng/ml/hr$) than the responder group did. Moreover, this group seemed to retain the ability to increase PRA in response to intravenous furosemide stimulation. Thus it became apparent that responder group was unable to increase PRA normally in response to furosemide as well as volume depletion, while poor responder seemed to retain that ability. Thus intravenous furosemode may serve as a convenient way to differenfiate those who might be benefited by conservative antihypertensive measures from those who would require more drastic measures such as bilateral nephrectomy for their optimal blood pressure control.

• 대한핵의학회지
• /
• 제13권1_2호
• /
• pp.23-29
• /
• 1979

To evaluate the renin-angiotensin-aldosterone system in diabetes mellitus, basal plasma renin activity (PRA) and its response to intravenous furosemide were determined in 40 diabetic subjects. The diabetics were divided into 4 groups according to the pressence of nephropathy and/or hypertension. Uncomplicated diabetics (Group I) were taken as control group and the results of the ether groups were compared to this group. In diabetics with nephropathy alone (Group II), and with nephropathy and hypertension (Group III), basal PRA values were $0.63{\pm}0.59ng/ml/hr.,\;and\;0.79{\pm}0.62ng/ml/hr.,$ respectively, both significantly lower than control group. ($1.53{\pm}1.09ng/ml/hr.$). (p<0.05) In both of the above groups, the responses to intravenous furosemide tended to be blunted. On the other hand, in diabetics with hypertension only (Group IV), the basal and stimulated PRA were not significantly different from control. Above results suggests that nephropathy may be one of the factors which suppress renin activity in diabetes mellitus.

• 대한핵의학회지
• /
• 제12권1호
• /
• pp.1-8
• /
• 1978

To find out a convenient and reliable method of. detecting low renin status, we employed intravenous furosemide injection as a stimulatory maneuver. The results thus obtained were compared with those from the postural stimuli and basal plasma renin activity (PRA) in relation to sodium excretion. Intravenous furosemide test was performed in 66 control subjects and 44 patients with essential hypertension. The results were as follow; 1) Mean PRA in control subjects rose from $2.5{\pm}1.95$ ng/ml/hr (basal) to $4.5{\pm}2.51,\;5.2{\pm}2.49\;and\;4.2{\pm}2.44$ ng/ml/hr at 1, 2 and 3hrs after IV injection. One-hour response is more convenient in clinical practice. 2) Postural stimuli by assuming an upright posture for 3 hrs gave rise to considerable increase in PRA ($4.0{\pm}2.92\;from\;2.4{\pm}1.85$), but we found it less convenient than stimulation with furosemide. 3) The increase in PRA was much less marked in patients with essential hypertension as a whole ($2.9{\pm}2.75$). Hyporesponsiveness to furosemide stimuli was found in 34.1%. Of these hypo responders, a third had a normal basal PRA, indicating the need for this kind stimulatory procedure. 4) Younger age group showed greater renin responsiveness than older age group after furosemide stimuli. Likewise mean age of low renin patients ($52.9{\pm}5.38$ years old) was significantly higher than that of high and normal renin patients ($44.1{\pm}13.78$ years old).

• 대한핵의학회지
• /
• 제10권1호
• /
• pp.1-14
• /
• 1976

The etiologic role of renin-angiotensin system and sodium-volume status in the pathophysiology of various forms of hypertension was investigated. Plasma renin activity (PRA) was measured by radioimmunoassay, while sodium-volume status was evaluated by the determination of total exchangeable sodium(NaE) using isotope dilution method. The subjects consisted of 25 controls, 24 patients with essential hypertension, with chronic renal failure (13 with hypertension, 9 without hypertension) and with malignant hypertension. The results were as follows: 1. An inverse correlation between NaE and PRA was noted in control subjects (r=-0.598, p<0.001) and normal renin essential hypertension(r=-0.551, p<0.05) and the chronic renal failure with hypertension. (r=-0.790, p<0.001) 2. NaE increased markedly the in chronic renal failure with hypertension ($66.9{\pm}8.69mEq/kg$ of LBM, p<0.001) and the chronic renal failure without hypertension ($54.9{\pm}9.28mEq/kg$ of LBM, p<0.05), while mild increase was noted in malignant hypertension ($51.7{\pm}6.24mEq/kg$ of LBM, 0.05$50.1{\pm}7.24mEq$) as well as in its renin subgroups.(p>0.1) 3. Absolute value of PRA was not deviated significantly from control group ($2.53{\pm}1.416ng/ml/hr$) except in malignant hypertension ($6.09{\pm}2.042$, p<0.001). But PRA was inappropriately high in relation to prevailing NaE in the chronic renal failure with hypertension (eleven of thirteen patients) and malignant hypertension (ten of fourteen patients), while PRA variatiation was within physiologic range in the chronic renal failure without hypertension. 4. The NaE-PRA product was markedly increased in the chronic renal failure with hypertension ($514.4{\pm}42.10$, p<0.001) and in malignant hypertension ($442.7{\pm}55.03$, p<0.001), while moderately increased NaE-PRA product was noted in the chronic renal failure without hypertension ($402.6{\pm}59.67$, p<0.001). No significant difference in NaE-PRA product was noted in essential hypertension ($354.4{\pm}62.38$, p>0.1). It is suggested that renin-angiotensin system plays a predominant role in the pathogenesis of malignant hypertension and in hypertension of chronic renal failure, though sodium retention is also contributing factor. PRA variation in essential hypertension does not appear to be associated with any consistent change in Na-volume status, suggesting the existence of another mechanism in the genesis of hypertension and PRA variation.

• The Korean Journal of Physiology
• /
• 제25권1호
• /
• pp.69-79
• /
• 1991

To evaluate the acute and chronic effects of potassium on aldosterone response to different amounts of sodium intake, two series of experiments were conducted. In the first series of experiments, when the plasma K level was increased acutely by KCI infusion $(20\;{\mu}g/kg/min\;for\;20 min)$, plasma aldosterone concentration increased in both low Na and high Na groups. However, the aldosterone response to K infusion was significantly greater in the low Na than in the high Na groups. In the second series of experiments, rats fed a high K diet chronically showed a significantly higher plasma K level than those fed a low K diet. However, plasma Na level was maintained relatively constant independent of the Na intake. Both the plasma renin activity (PRA) and aldosterone levels were inversely related to the Na intake. There was a highly positive correlation between aldosterone level and PRA over a wide range of sodium intakes. However, the slope of the correlation line was distinctly steeper in the K-repleted than in the K-depleted rats. The above results indicate that the adrenotropic action of acute K load was augmented in the presence of high plasma renin levels. However, when plasna K level was elevated chronically by a high-K diet, aldosterone secretion was markedly stimulated, although the plasma lenin levels were suppressed.