Aldosterone-renin ratio (ARR) is the most reliable method for screening for primary aldosteronism. Primary aldosteronism occurs when aldosterone production is inappropriately high in relation to the patient’s sodium status. The aldosterone to renin ratio test (ARR) is determined by measuring both aldosterone and renin levels.
Primary aldosteronism (PA) is defined as a group of disorders in which aldosterone production is inappropriately high, relatively autonomous, and not suppressible by sodium loading. This inappropriate production of aldosterone can result in cardiovascular damage, suppression of plasma renin, hypertension, sodium retention, and potassium excretion that can lead to hypokalemia. PA is commonly caused by an adrenal adenoma, by unilateral or bilateral adrenal hyperplasia, or, in rare cases, by the inherited condition of glucocorticoid-remediable aldosteronism (GRA).