MAY 10, 2013 9:00 AM PDT

Renin: Clinical Utility of Renin Measurement in Hypertension

Sponsored by: DiaSorin, DiaSorin
Speaker
  • Assistant Professor of Medicine at Harvard Medical School and Associate Physician at Brigham and Women's Hospital, Division of Endocrinology
    Biography
      Dr. Williams is an Assistant Professor of Medicine at Harvard Medical School and Associate Physician at Brigham and Women's Hospital, Division of Endocrinology, Diabetes, and Hypertension.  He has dedicated his research efforts to unravelling the intricate relationship between genetics and environment with respect to individual susceptibility to cardiometabolic disease.  He has over 40 original publications describing the physiologic and pathologic interplay of renin-angiotensin-aldosterone system activity and dietary salt intake in hypertension, insulin resistance, heart disease, and obesity.  His work is funded through National Institutes of Health, industry, and private foundation support.
       
      Dr. Williams is an active program developer, course director, and mentor for the Harvard Medical School's Scholars in Clinical Research Program, which is a Master's degree granting program designed to train the upcoming generation of patient-oriented physician scientists.  He is also an Associate Editor of the journal Metabolism, and serves on the Board of Directors for the Association for Patient-oriented Research and for the Association for Clinical and Translational Science.

    Abstract

     

    Measurement of renin and its activity is increasingly used in the evaluation of circulatory function. This is primarily driven by a higher than previously realized prevalence of primary hyperaldosteronism. Renin measurement is also useful in evaluation of adrenal insufficiency, hypertension with hypokalemia, and assessment of suspected renin hypofunction.  Renin measurement in the assessment of renovascular causes of hypertension has fallen out of favor due to poor predictive capacity in most situations.  Measurement of renin typically occurs via two means.  Plasma renin activity provides a measure of enzymatic performance by calculating the rate of angiotensin I formation by renin.  Alternatively, renin can be directly measured by assessing the mass of renin in concentration.  Physiologic conditions are important modifiers of renin activity. These include body posture, dietary salt intake, diurnal variation, age, race, renal disease, and confounding medications.  As renin determination becomes more widely used in clinical practice, a solid understanding of assay limitations and the host of factors that influence renin activity will be required to properly interpret results.

     


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