TL;DR
Under conditions of ongoing antihypertensive medication use, UARR exhibits excellent diagnostic accuracy (AUC = 0.862) for primary aldosteronism screening, whereas 24h-Uald alone demonstrates only modest diagnostic performance (AUC = 0.657).
Key Findings
Results
Both 24h-Uald and UARR levels were significantly higher in patients with PA than in those with essential hypertension.
Comparison was statistically significant (P < 0.05) for both biomarkers.
Patients were retrospectively enrolled from a single hospital between August 2024 and August 2025.
All measurements were taken while patients were receiving ongoing antihypertensive therapy.
Baseline clinical characteristics and biochemical parameters were collected under medication-exposed conditions.
Results
After adjustment for potential confounders, 24h-Uald and UARR remained independently associated with PA.
Multivariable logistic regression analysis was used to assess independent associations.
Confounders adjusted for included age, body mass index, renal function, and history of coronary artery disease.
Both biomarkers maintained statistical significance after adjustment.
Results
UARR demonstrated excellent diagnostic accuracy for PA screening in medication-exposed patients.
ROC curve analysis showed UARR achieved an AUC of 0.862.
UARR incorporates renin measurements alongside urinary aldosterone.
This performance was achieved under conditions of ongoing antihypertensive medication use.
Results
24h-Uald alone demonstrated only modest diagnostic performance for PA screening in medication-exposed patients.
ROC curve analysis showed 24h-Uald achieved an AUC of 0.657.
The diagnostic performance was characterized as 'modest' by the authors.
The limited performance occurred specifically under conditions of ongoing antihypertensive medication use.
Conclusions
UARR demonstrated higher diagnostic accuracy and greater clinical utility compared to 24h-Uald alone for PA screening.
AUC for UARR was 0.862 versus 0.657 for 24h-Uald.
The authors concluded that UARR, by incorporating renin measurements, provides superior clinical utility.
The study population consisted of hypertensive patients undergoing PA screening while on antihypertensive therapy.
Have a question about this study?
Citation
Chen S, Chen K, Wu J, Yang J, Shen L, Yuan H. (2026). Diagnostic value of 24-h urinary aldosterone and related biomarkers for screening primary aldosteronism in medication-exposed populations.. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2026.1792072
Copy