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Aldosterone and Renin, Direct with Ratio
2002582
Ordering Recommendation

Diagnose and screen for primary 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
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 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.
CPT Code(s)
82088; 84244
Components
Component Test Code*Component Chart NameLOINC
0070015Aldosterone1763-2
2001576Direct Renin2915-7
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