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Aldosterone/Renin Activity Ratio
0070073
Ordering Recommendation

Diagnose and screen for primary hyperaldosteronism.

Mnemonic
A/RA
Methodology
Quantitative Chemiluminescent Immunoassay/Quantitative Enzyme-Linked Immunosorbent Assay
Performed
Sun-Sat
Reported
1-5 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Normal sodium diet (100-200 mEq/day) for at least three days. Receiving no medications known to affect renin-aldosterone system.
Supine:
Both specimens should be obtained between 8 a.m. and 10 a.m. (after at least two hours in supine position).
OR
Upright:
Both specimens should be obtained before noon (after at least two hours in upright position, seated or standing).
Contact Medical Director if more information is needed. 
Collect
From either a supine or upright patient, Serum Separator Tube (SST) AND Lavender (EDTA) or Pink (K2EDTA). Do not collect in refrigerated tubes. 
Specimen Preparation
Separate from cells ASAP or within 2 hours of collection.
Serum: Transfer 1 mL serum to an ARUP Standard Transport Tube. (Min: 0.5 mL)
AND 
Plasma: Transfer 2 mL EDTA plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 1.2 mL) 
Storage/Transport Temperature
Both specimens should be submitted together for testing.
Serum:
Frozen. Also acceptable: Refrigerated.
Plasma: CRITICAL FROZEN.  Separate specimens must be submitted when additional tests are ordered.
 
Unacceptable Conditions
Plasma collected in citrate, heparin, or oxalate. Hemolyzed specimens. 
Remarks
 
Stability
Serum: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 1 month
Plasma: Ambient: 6 hours; Refrigerated: Unacceptable; Frozen: 1 month 
Reference Interval
Test Number
Components
Reference Interval
0070015Aldosterone, SerumEffective May 16, 2011
Age
Posture Unspecified
Supine
Upright
0-6 days5.0-102.0 ng/dL
1-3 weeks6.0-179.0 ng/dL
1-11 months7.0-99.0 ng/dL
1-2 years7.0-93.0 ng/dL
3-10 years4.0-44.0 ng/dL
11-14 years4.0-31.0 ng/dL
15 years and olderLess than or equal to 31.0 ng/dLLess than or equal to 16.0 ng/dL4.0-31.0 ng/dL

0070105Renin Activity
Adult, normal sodium diet
Children, normal sodium diet, supine:
Children, normal sodium diet, upright:
Supine: 0.2-1.6 ng/mL/hrNewborn (1-7 days): 2.0-35.0 ng/mL/hr0-3 years: Not Available
Upright: 0.5-4.0 ng/mL/hrCord blood: 4.0-32.0 ng/mL/hr4-5 years: Less than or equal to 15 ng/mL/hr
1-12 months: 2.4-37.0 ng/mL/hr6-10 years: Less than or equal to 17 ng/mL/hr
13 months-3 years:1.7-11.2 ng/mL/hr11-15 years: Less than or equal to 16 ng/mL/hr
4-5 years:1.0-6.5 ng/mL/hr
6-10 years: 0.5-5.9 ng/mL/hr
11-15 years: 0.5-3.3 ng/mL/hr

 Aldosterone/Renin Activity CalculationEffective May 16, 2011

Less than 25
An Aldosterone/Renin Activity Ratio of greater than 25 is suggestive of hyperaldosteronism if the aldosterone concentration is greater than 15 ng/dL.


Interpretive Data


Compliance Statement D: This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Note
CPT Code(s)
82088; 84244
Components
Component Test Code*Component Chart NameLOINC
0070015Aldosterone1763-2
0070074Aldosterone/Renin Activity Calculation30894-0
0070105Renin Activity2915-7
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Aldosterone and Plasma Renin Activity
  • Aldosterone serum
  • Aldosterone/Renin Activity
  • ARR
  • ARR-P
  • PRA
  • Renin Activity