Aldosterone and Renin, Direct with Ratio
Ordering Recommendation
Diagnose and screen for primary hyperaldosteronism.
Quantitative Chemiluminescent Immunoassay/Quantitative Immunoradiometry
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
1. Both specimens should be obtained between 8 a.m. and 10 a.m. (after at least two hours in supine position);
2. Normal sodium diet (100-200 mEq/day) for at least three days;
3. Receiving no medications known to affect renin-aldosterone system.

1. Both specimens should be obtained before noon (after at least two hours in upright position; seated or standing).
2. Normal sodium diet (100-200 mEq/day) for at least three days.
3. Receiving no medications known to affect renin-aldosterone system.
Contact Medical Director if more information is needed.  
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. Transfer 1 mL serum AND 2 mL EDTA plasma to individual ARUP Standard Transport Tubes and freeze immediately. (Min: 0.5 mL serum AND 1 mL EDTA plasma)  
Storage/Transport Temperature
CRITICAL FROZEN.  Separate specimens must be submitted when additional tests are ordered.  
Unacceptable Conditions
Refrigerated plasma. Hemolyzed specimens.  
After separation from cells: Ambient: 8 hours; Refrigerated: Unacceptable; Frozen: 1 month  
Reference Interval
Available Separately
Reference Interval
0070015Aldosterone, SerumEffective May 16, 2011
Posture Unspecified
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.

Do not use this test for patients treated with Cathepsin B.
CPT Code(s)
82088; 84244
Component Test Code*Component Chart NameLOINC
2001576Direct Renin2915-7
2002583Aldosterone/Direct Renin Calculation30894-0
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  • Aldosterone and Direct renin
  • aldosterone serum
  • aldosterone/direct renin calculation
  • Aldosterone/Renin Ratio
  • ARR
  • ARR-D
  • DRA
  • Renin direct