What is the role of plasma renin activity in the workup of metabolic alkalosis?

Updated: Dec 10, 2020
  • Author: Christie P Thomas, MBBS, FRCP, FASN, FAHA; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Measuring the plasma renin activity and aldosterone level may help in finding the etiology of metabolic alkalosis, especially in patients with hypertension, hypokalemic metabolic alkalosis, and renal potassium wasting without diuretic use. Low renin activity and high plasma aldosterone levels are found in primary hyperaldosteronism, including glucocorticoid-remediable hyperaldosteronism.

Low plasma renin activity and aldosterone levels are found in the following circumstances:

  • Cushing syndrome

  • Exogenous steroid use

  • Congenital adrenal hyperplasia (CAH)

  • 11-beta-hydroxysteroid dehydrogenase (11B-HSD) deficiency

  • deoxycorticosterone (DOC)-secreting tumors

  • Liddle syndrome

High plasma renin activity and aldosterone levels are found in the following circumstances:

  • Renal artery stenosis

  • Diuretic use

  • Renin-secreting tumors

  • Bartter syndrome

  • Gitelman syndrome


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