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Renin, also known as angiotensinogenase, is an enzyme that participates in the bodys renin-angiotensin system (RAS) that mediates extracellular volume and arterial vasoconstriction. Thus it regulates the bodys mean arterial blood pressure. Renin is released from the kidneys when there is a drop in blood pressure, a decrease in sodium concentration, or an increase in potassium concentration. It cleaves the blood protein angiotensinogen to form angiotensin I, which is then converted by a second enzyme to angiotensin II. Angiotensin II causes blood vessels to constrict, and it stimulates the production of aldosterone. The overall effect is to raise blood pressure and keep sodium and potassium at normal levels. This test is useful in the diagnosis of renovascular hypertension. INCREASED levels may indicate: addisons disease, cirrhosis, dehydration, hemorrhage (bleeding), high blood pressure, hypokalemia, malignant hypertension, nephrotic syndrome, and renovascular hypertension. REDUCED levels are associated with primary hyperaldosteronism (Conns syndrome) and hyperadrenocorticism (e.g. Cushings syndrome).
Do not use this test for patients treated with Cathepsin B. Menstruating females and those taking estrogen-containing medications may have lower renin direct concentrations, resulting in falsely high aldosterone-renin ratio (ARR). In these cases, order Aldosterone/Renin Activity Ratio (ARUP Test code 0070073). Refer to the Additional Technical Information for Endocrine Society recommendations for patient preparation, specimen collection, medications for hypertension control during confirmatory testing for primary aldosteronism, and factors that may lead to false-positive or false-negative ARR results.