Renin-Guided Therapy

Risks & contraindications

Evidence quality

Other

Highlighted claims

• The renin-guided arm prioritises MRA up-titration until renin becomes unsuppressed before addressing potassium and blood pressure with other drugs. — Renin-guided therapy with mineralocorticoid receptor antagonists in primary aldosteronism: feasibility study (RETAME-PA) — a clinical research protocol for a randomised controlled trial
• MRA up-titration in the renin-guided arm stops if treatment is not tolerated or potassium exceeds 4.8 mmol/L. — Renin-guided therapy with mineralocorticoid receptor antagonists in primary aldosteronism: feasibility study (RETAME-PA) — a clinical research protocol for a randomised controlled trial
• The 2025 Endocrine Society guideline supports up-titrating MRAs when blood pressure is uncontrolled and renin remains suppressed, but the evidence certainty is very low. — Renin-guided therapy with mineralocorticoid receptor antagonists in primary aldosteronism: feasibility study (RETAME-PA) — a clinical research protocol for a randomised controlled trial
• The guideline does not resolve whether to increase MRAs when renin is suppressed but blood pressure is already controlled on MRA monotherapy. — Renin-guided therapy with mineralocorticoid receptor antagonists in primary aldosteronism: feasibility study (RETAME-PA) — a clinical research protocol for a randomised controlled trial
• RETAME-PA tests whether proactive physician-led renin-guided titration can drive higher biochemical normalisation than traditional markers or patient characteristics. — Renin-guided therapy with mineralocorticoid receptor antagonists in primary aldosteronism: feasibility study (RETAME-PA) — a clinical research protocol for a randomised controlled trial