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Dr. Grim,What do the labs look like for aldosterone, renin and the A/R ratio in the instance of glucocorticoid remediable aldosteronism? I've searched the literature and found the diagnostic procedure, but I haven't found any discussion of how GRA impacts aldosterone and renin levels. Would a ratio of 7.5 rule out GRA? A/R of 5.0/0.65 seems to rule out Conn's. Does it

rule out GRA also? Would renin have to fall lower due to failure of the feedback loop to regulate salt and water at setpoint?

What effect would Cushing's disease have on aldosterone, renin and A/R ratio? It seems like Cushing's could cause edema and hypertension by overwhelming the capacity of 11-beta hydroxysteroid dehydrogenase to guard mineralcorticoid receptors from cortisol stimulation.

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