The Benefits of Comprehensive Renin Testing Capabilities
By Dr. Matthias Herkert, DRG International
Posted on 11 Aug 2010
In the United States, one third of the American adults have high blood pressure or hypertension, and among those, almost one third even do not know that they had the condition. Even worse, among those who received treatment, only one third had their blood pressure under control. However, hypertension increases the chance for developing heart disease, stroke and other serious health conditions.
In today's hard economic environment, time – and money – are of the essence. In the world of medical testing, doctors, nurses, and practitioners struggle to find the most significant and still cost-effective tools to offer patients quality care and early warning.
The enzyme Renin is a key factor in the regulation of arterial blood pressure. Renin belongs to the Renin-Angiotensin-Aldosterone System (RAAS) that controls blood pressure, renal blood flux, glomerular filtration, and the body's balance of electrolytes and fluids. Plasma active Renin is a good index for the activity of the RAAS. In case of dysfunction of the RAAS, the Renin assay will allow clinical implications for diagnosis, treatment, and follow up.
The juxtaglomerular cells of the kidneys produce Renin as a reaction to low intra-renal blood pressure, reduced sodium reabsorption, hypokalemia or activity of the sympathetic nervous system. When active Renin enters the bloodstream, it mediates cleavage of angiotensinogen into the precursor peptide angiotensin I, and ultimately leads to the production of angiotensin II, which causes a rise in blood pressure, while the increase of aldosterone helps the body to retain sodium. Once blood pressure has been stabilized, the additional Renin and aldosterone which were created are metabolized, and the body ceases their productions.
In some patients, the kidneys continue to produce Renin after blood pressure has been stabilized. This causes the patient's blood pressure to rise. While dietary changes can alleviate the problem, it is sometimes necessary to take other measures. In these cases, doctors may request Renin tests in order to get a better estimate of Renin levels in the body and to see if Renin overproduction is the cause of a patient's blood pressure problems.
Normal Renin values range from 1.9 to 40 pg/mL. A high Renin value can be a harbinger for kidney disease, a blocked artery located close to a kidney, Addison's disease, cirrhosis, a hemorrhage, or malignant high blood pressure. Conversely, low Renin values may indicate the presence of Conn's syndrome. Either condition is potentially life threatening. According to the Centers for Disease Control and Prevention, there were 23,965 hypertension-related deaths in 2007.
Active Renin is an important marker for hypertensive patients and for the therapeutic follow up of high blood pressure. With a third of the US population affected by the disease, it is important to be able to get a high volume of tests accomplished with efficiency. This advancement is an important achievement for laboratory efficiency and expediency for patient results.
Existing methods to estimate Renin in blood either determined Renin activity or specifically measured the concentration of the active Renin. Both approaches had drawbacks as they either needed additional sample extraction, used radioactive quantification or were available only as closed systems.
Dr. Matthias Herkert is the Senior Scientist in the research and development department of DRG Instruments GmbH, a wholly owned subsidiary of DRG International. DRG International's active Renin ELISA is the first non-radioactive open system, that allows for quantification of active Renin testing without extraction.
At DRG, Dr. Herkert is responsible for development of new ELISA kits. He also oversees collaboration with project partners, including university hospitals and research groups. In addition, Dr. Herkert represents DRG in National and International Congresses. With approximately 20 years of experience at leading institutions, Dr. Herkert has a strong theoretical and practical knowledge in the fields of biochemistry and neuroscience, as well as ELISA assay development.
Founded in 1970 by Dr. Cyril E. Geacintov, DRG International, Inc. is a leading specialty medical equipment and diagnostics manufacturer with operations in more than 100 countries.