Pre Test Infomation: Patient should be ambulatory / upright 2 hours prior to the test. Drug interactions to be noted: Potassium wasting diuretics, Spironolactone, Eplerenone, Amiloride and Triamterene should be dicontinued at least for 4 weeks; Adrenergic blockers, Clonidine, Methyldopa, NSAIDs, Angiotensin-converting enzyme inhibitors, Angiotensin receptor blockers, Renin inhibitors and Dihydropyridine calcium channel antagonists should be discontinued for 2 weeks. If necessary to maintain hypertension control, patients should be treated with other antihypertensive medications like Verapamil slow-release, Hydralazine, Prazosin, Doxazosin & Terazosin that have lesser effects on Plasma renin levels. Any change in medication should be done in consultation with treating clinician.
Renin is a proteolytic enzyme released from juxtaglomerular cells of the kidney. The enzyme cleaves a substrate to produce Angiotensin I which in turn produces Angiotensin II. This metabolite plays a key role in various forms of hypertension. Increased levels are seen in Renal hypertension, Addison’s disease and Secondary hypoaldosteronism. Low levels are detected in Hyporeninemic hypoaldosteronism and Primary aldosteronism.