Table 2.

Drugs and conditions that affect aldosterone, renin, and aldosterone-renin ratio.

Factor	Effect on PAC levels	Effect on renin levels	Effect on ARR
Serum potassium status
Hypokalemia	↓	→↑	↓ (FN)
Potassium loading	↑	→↓	↑
Dietary sodium
Sodium restriction	↑	↑↑	↓ (FN)
Sodium loading	↓	↓↓	↑ (FP)
Drugs
β-Adrenergic blockers	↓	↓↓	↑ (FP)
Calcium channel blockers (DHPs)	→↓	↑	↓ (FN)
ACE inhibitors	↓	↑↑	↓ (FN)
ARBs	↓	↑↑	↓ (FN)
K+-sparing diuretics	↑	↑↑	↓ (FN)
K+-wasting diuretics	→↑	↑↑	↓ (FN)
Clonidine
α-methyldopa	↓	↓↓	↑ (FP)
NSAIDs	↓	↓↓	↑ (FP)
Steroids	↓	→↓	↑ (FP)
Contraceptive agents (drosperinone)	↑	↑	↑ (FP)
Clinical conditions
Old age	↓	↓↓	↑ (FP)
CKD	→	↓	↑ (FP)
Pregnancy	↑	↑↑	↓ (FN)
Renovascular HT	↑	↑↑	↓ (FN)
Malignant HT	↑	↑↑	↓ (FN)

PAC, plasma aldosterone concentration; ARR, aldosterone-renin-ratio; DHPs, dihydropyridines; ACE, angiotensin-converting enzyme; ARBs, angiotensin II type 1 receptor blockers; K⁺, potassium; NSAIDs, non-steroidal anti-inflammatory drugs; FP, HT, hypertension; false positive; FN, false negative.

Adapted from J. W. Funder et al.: The management of Primary Aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 ​101(5):1889–1916 [1]