Abstract
Objectives
The aim of this study was to determine the appropriate transport and storage conditions for blood taken for direct renin concentration and plasma renin activity measurement, and whether cryoactivation of prorenin is seen at time points relevant to clinical practice.
Methods
Blood was extracted from n=10 volunteers into K2-EDTA tubes. Stability of renin was assessed in whole blood stored at room temperature (15–25 °C) and in the refrigerator (2–8 °C) at 0 h, 8 h, and 24 h. The stability of renin in plasma was determined under the same conditions at 0 h, 24 h and 72 h.
Results
Stability of plasma renin activity and direct renin concentration in whole blood stored at room temperature was found to be acceptable for up to 24 h. At refrigerated temperature, whole blood stability was acceptable for measurement of direct renin concentration up to 8 h and plasma renin activity up to 24 h. In contrast, plasma renin activity was not stable in plasma stored at either room or refrigerated temperatures up to 24 h; however, direct renin concentration had acceptable stability in plasma stored at room temperature for up to 24 h, but stability was unacceptable at refrigerated temperatures.
Conclusions
Samples collected for plasma renin activity and direct renin concentration should be transported as whole blood to optimise stability. After sample processing, plasma can be kept at room temperature for up to 24 h for direct renin concentration, however, for determination of plasma renin activity separated plasma should be analysed or frozen as soon as possible.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: Not applicable.
References
1. Saravi, B, Li, Z, Lang, CN, Schmid, B, Lang, FK, Grad, S, et al.. The tissue renin-angiotensin system and its role in the pathogenesis of major human diseases: quo vadis? Cells 2021;10:1–23. https://doi.org/10.3390/cells10030650.Search in Google Scholar
2. El-Asmar, N, Rajpal, A, Arafah, BM. Primary hyperaldosteronism: approach to diagnosis and management. Med Clin 2021;105:1065–80. https://doi.org/10.1016/j.mcna.2021.06.007.Search in Google Scholar
3. Hsueh, WA, Baxter, JD. Human prorenin. Hypertension 1991;17:469–77. https://doi.org/10.1161/01.hyp.17.4.469.Search in Google Scholar
4. Pitarresi, TM, Rubattu, S, Heinrikson, R, Sealey, JE. Reversible cryoactivation of recombinant human prorenin. J Biol Chem 1992;267:11753–9. https://doi.org/10.1016/s0021-9258(19)49762-7.Search in Google Scholar
5. Sealey, JE, Atlas, SA, Laragh, JH, Silverberg, M, Kaplan, AP. Initiation of plasma prorenin activation by Hageman factor-dependent conversion of plasma prekallikrein to Kallikrein. Proc Natl Acad Sci U S A 1979;76:5914–8. https://doi.org/10.1073/pnas.76.11.5914.Search in Google Scholar PubMed PubMed Central
6. Osmond, DH, Ross, LJ, Scaiff, KD. Increased renin activity after cold storage of human plasma. Can J Physiol Pharmacol 1973;51:705–8. https://doi.org/10.1139/y73-107.Search in Google Scholar PubMed
7. Sealey, JE. Plasma renin activity and plasma prorenin assays. Clin Chem 1991;37:1811–9. https://doi.org/10.1093/clinchem/37.10.1811.Search in Google Scholar
8. Lapworth, R, Green, SE, Short, F. In vitro stability of assayed renin activity in plasma and whole blood. Ann Clin Biochem 1990;27:78–9. https://doi.org/10.1177/000456329002700117.Search in Google Scholar PubMed
9. Stirati, G, de Martino, A, Menè, P, Pierucci, A, Simonetti, BM, Feriozzi, S, et al.. Plasma renin activity: effect of temperature during blood processing. J Clin Chem Clin Biochem 1983;21:529–31.Search in Google Scholar
10. Brossaud, J, Corcuff, JB. Pre-analytical and analytical considerations for the determination of plasma renin activity. Clin Chim Acta 2009;410:90–2. https://doi.org/10.1016/j.cca.2009.09.018.Search in Google Scholar PubMed
11. Locsei, Z, Racz, K, Patocs, A, Kovacs, GL, Toldy, E. Influence of sampling and storage conditions on plasma renin activity and plasma renin concentration. Clin Chim Acta 2009;402:203–5. https://doi.org/10.1016/j.cca.2009.01.013.Search in Google Scholar PubMed
12. Ulmer, PS, Meikle, AW. Sample requirements for plasma renin activity and immunoreactive renin. Clin Chem 2000;46:1442–4. https://doi.org/10.1093/clinchem/46.9.1442a.Search in Google Scholar
13. Rutledge, AC, Johnston, A, Bailey, D, Booth, RA, Edmond, P, Leung, V, et al.. Survey of renin and aldosterone testing practices by Ontario laboratorios – providing insight into best practices. Pract Lab Med 2021;25:e00229. https://doi.org/10.1016/j.plabm.2021.e00229.Search in Google Scholar PubMed PubMed Central
14. Cornes, M, Simundic, AM, Cadamuro, J, Costelloe, SJ, Baird, G, Kristensen, GBB, et al.. The CRESS checklist for reporting stability studies: on behalf of the European federation of clinical chemistry and laboratory medicine (EFLM) working group for the preanalytical phase (WG-PRE). Clin Chem Lab Med 2020;59:59–69. https://doi.org/10.1515/cclm-2020-0061.Search in Google Scholar PubMed
15. Simundic, A-M, Bölenius, K, Cadamuro, J, Church, S, Cornes, MP, van Dongen-Lases, EC, et al.. Joint EFLM-COLABIOCLI recommendation for venous blood sampling. Clin Chem Lab Med 2018;56:2015–38. https://doi.org/10.1515/cclm-2018-0602.Search in Google Scholar PubMed
16. Sealey, JE, Blumenfeld, J, Laragh, JH. Prorenin cryoactivation as a possible cause of normal renin levels in patients with primary hyperaldosteronism. J Hypertens 2005;23:459–60. https://doi.org/10.1097/00004872-200502000-00030.Search in Google Scholar PubMed
17. Hillebrand, JJ, Heijboer, AC, Endert, E. Effects of repeated freeze-thaw cycles on endocrine parameters in plasma and serum. Ann Clin Biochem 2017;54:289–92. https://doi.org/10.1177/0004563216657361.Search in Google Scholar PubMed
18. Gruson, D, Maisin, D, Lison, P, Maiter, D, Persu, A. Two-site automated chemiluminescent assay for measurement of immunoreactive renin. Biomarkers 2011;16:605–9. https://doi.org/10.3109/1354750x.2011.614015.Search in Google Scholar
19. Van Der Gugten, JG, Holmes, DT. Chapter 26. Quantitation of plasma renin activity in plasma using liquid-chromatography – tandem mass spectrometry (LC-MS/MS). In: Garg, U, editor. Clinical applications of mass spectrometry in biomolecular analysis. Methods in Molecular Biology. New York: Humana Press; 2016, vol 1378.10.1007/978-1-4939-3182-8_26Search in Google Scholar PubMed
20. Aarsand, AK, Fernandez-Calle, P, Webster, C, Coskun, A, Gonzales-Lao, E, Diaz-Garzon, J, et al. The EFLM biological variation database. Available from: https://biologicalvariation.eu/search?q=renin [Accessed 17 Jan 2022].Search in Google Scholar
21. Gómez-Rioja, R, Amaro, MS, Diaz-Garzón, J, Baucà, JM, Espartosa, DM, Fernández-Calle, P. A protocol for testing the stability of biochemical analytes. Technical document. Clin Chem Lab Med 2019;57:1829–36. https://doi.org/10.1515/cclm-2019-0586.Search in Google Scholar PubMed
22. Center for Biomathematics, Columbia University Medical Center. Available from: biomath.info [Accessed 28 Mar 2021].Search in Google Scholar
23. Chakera, AJ, McDonald, TJ, Knight, BA, Vaidya, B, Jones, AG. Current laboratory requirements for adrenocorticotropic hormone and renin/aldosterone sample handling are unnecessarily restrictive. Clin Med (London) 2017;17:18–21. https://doi.org/10.7861/clinmedicine.17-1-18.Search in Google Scholar PubMed PubMed Central
24. Carter, S, Owen, LJ, Kerstens, MN, Dullaart, RPF, Keevil, BG. A liquid chromatography tandem mass spectrometry assay for plasma renin activity using online solid-phase extraction. Ann Clin Biochem 2012;49:570–9. https://doi.org/10.1258/acb.2012.011186.Search in Google Scholar PubMed
25. Glinicki, P, Jeske, W, Gietka-Czernel, M, Bednarek-Papierska, L, Kruszyńska, A, Słowińska-Srzednicka, J, et al.. The effect of blood collection procedure on plasma renin activity (PRA) and concentrations of direct renin (DRC) and aldosterone. J Renin-Angiotensin-Aldosterone Syst JRAAS 2015;16:339–43. https://doi.org/10.1177/1470320313494434.Search in Google Scholar PubMed
26. Campbell, DJ, Nussberger, J, Stowasser, M, Jan Danser, AH, Morganti, A, Frandsen, E, et al.. Activity assays and immunoassays for plasma renin and prorenin: information provided and precautions necessary for accurate measurement. Clin Chem 2009;55:867–77. https://doi.org/10.1373/clinchem.2008.118000.Search in Google Scholar PubMed
27. Sealey, JE, Gordon, RD, Mantero, F. Plasma renin and aldosterone measurements in low renin hypertensive states. Trends Endocrinol Metab 2005;16:86–91. https://doi.org/10.1016/j.tem.2005.02.006.Search in Google Scholar PubMed
28. Hsueh, WA, Luetscher, JA, Carlson, EJ, Grislis, G, Fraze, E, McHargue, A. Changes in active and inactive renin throughout pregnancy. J Clin Endocrinol Metab 1982;54:1010–6. https://doi.org/10.1210/jcem-54-5-1010.Search in Google Scholar PubMed
29. Rowe, J, Gallery, ED, Gyory, AZ. Cryoactivation of renin in plasma from pregnant and nonpregnant subjects, and its control. Clin Chem 1979;25:1972–4. https://doi.org/10.1093/clinchem/25.11.1972.Search in Google Scholar
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