Current laboratory requirements for adrenocorticotropic hormone and renin/aldosterone sample handling are unnecessarily restrictive.
Royal College of Physicians
Reason for embargo
Samples for adrenocorticotropic hormone (ACTH) and aldosterone/renin analysis usually require rapid transport to the receiving laboratory for immediate separation and freezing. In practice, this means assessment is limited to hospital settings and many samples are rejected. We examined whether these requirements are necessary by assessing the stability of ACTH, aldosterone and renin over 48 hours in whole blood collected in serum gel and EDTA plasma from 31 participants. Our results show that ACTH collected into EDTA plasma is stable at room temperature for at least 6 hours, mean change at 6 hours -2.6% (95% CI -9.7 to 4.5). Both aldosterone and renin were stable collected on serum gel at room temperature for at least 6 hours: mean change aldosterone +0.2% (95% CI -3.6 to 4.0), renin -1.9% (95% CI -7.0 to3.2). Therefore, by using appropriate preservatives, ACTH and aldosterone/renin can be measured on samples collected at room temperature and processed within 6 hours. This would facilitate outpatient and emergency room assessment of these analytes.
This project was funded by the Royal Devon and Exeter NHS Foundation Trust NIHR Small Grant Scheme and by the Exeter NIHR Clinical Research Facility. AGJ was an NIHR doctoral research fellow and is an NIHR clinician scientist. TJM is an NIHR CSO fellow. BAK is a core staff member of the NIHR Exeter Clinical Research Facility.
This is the author accepted manuscript. The final version is available from the publisher via the DOI in this record.
Vol. 17, pp. 18 - 21
Place of publication