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Aldosterone and Renin, Direct with Ratio
2002582
Ordering Recommendation

Screen and diagnose hyperaldosteronism.

Mnemonic
A/DR
Methodology
Quantitative Chemiluminescent Immunoassay/Quantitative Immunoradiometry
Performed
Mon
Reported
1-8 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Collect midmorning after patient has been sitting, standing or walking for at least 2 hours and seated for 5-15 minutes. Refer to the Additional Technical Information for specific patient preparation recommendations. 
Collect
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: 0.5mL)
AND
Plasma: Transfer 2 mL EDTA plasma to an ARUP Standard Transport Tube and freeze immediately. (Min: 1 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: 4 hours; Refrigerated: Unacceptable; Frozen: 1 month 
Reference Interval
Available Separately
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

2001575Renin, Direct2.5-45.7 pg/mL
Aldosterone/Direct Renin Calculation0.1-3.7

An Aldosterone/Direct Renin Ratio of greater than 3.7 is suggestive of hyperaldosteronism.

Interpretive Data
Normal serum levels of aldosterone are dependent on the sodium intake and whether the patient is upright or supine. High sodium intake will tend to suppress serum aldosterone, whereas low sodium intake will elevate serum aldosterone. The reference intervals for serum aldosterone are based on normal sodium intake.

Note
Do not use this test for patients treated with Cathepsin B. Menstruating females and those taking estrogen containing medications may have lower renin direct concentrations, resulting in falsely high aldosterone-renin ratio (ARR). In these cases, order Aldosterone/Renin Activity Ratio (ARUP Test code 0070073). Refer to the Additional Technical Information for Endocrine Society recommendations for patient preparation, specimen collection, medications for hypertension control during confirmatory testing for primary aldosteronism, and factors that may lead to false-positive or false-negative ARR results.
Components
Component Test Code*Component Chart NameLOINC
0070015Aldosterone1763-2
2001576Direct Renin35570-1
2002583Aldosterone/Direct Renin Calculation30894-0
* 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 Direct renin
  • aldosterone serum
  • aldosterone/direct renin calculation
  • Aldosterone/Renin Ratio
  • ARR
  • ARR-D
  • DRA
  • Renin direct