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Is the Renin-Sodium Profile Helpful in Evaluating Hypertension?

Ray W. Gifford, MD
JAMA. 1980;244(1):35-37. doi:10.1001/jama.1980.03310010021020.
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LARAGH and colleagues1 have long advocated measurement of plasma renin activity (PRA) routinely in the evaluation of hypertensive patients. They have presented an elaborate and somewhat complicated schema for using the PRA as an aid in diagnostic evaluation and in selecting drugs. Reliable measurements of PRA are not readily available to many physicians, and when they are, care must be taken to control, so far as is possible, those variables that influence PRA, such as physical activity, normal diurnal variations, drugs (eg, estrogens, diuretics, and antihypertensive agents), and sodium intake. Laragh et al recommend that blood be drawn at the same time of day (noon), after the patient has been ambulatory for several hours, and that the urinary sodium excretion for the previous 24 hours be measured to estimate the state of sodium balance. Does the information provided by a renin-sodium profile justify this meticulous attention to detail and the


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