Ordering Recommendation

Screen and diagnose hyperaldosteronism.

Mnemonic

A/DR

Methodology

Quantitative Chemiluminescent Immunoassay

Performed

Mon, Wed, Fri

Reported

1-5 days

New York DOH Approval Status

This test is New York DOH approved.

Specimen Required

Patient Preparation

Collect midmorning (i.e., 7am10am) after patient has been sitting, standing, or walking for at least 30 minutes and seated for 5-15 minutes. If the patient is supine, ensure that the patient is in this position for at least 30 minutes prior to collection. Fasting specimens are recommended but not required.

Collect

Serum separator tube (SST) AND lavender (EDTA) from a supine or upright patient. Do not collect in refrigerated tubes nor store tubes on ice. Process blood at room temperature and centrifuge tubes in a nonrefrigerated centrifuge.

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 collected and submitted together for testing.
Serum:
Frozen. Also acceptable: Refrigerated.
Plasma: Frozen

Unacceptable Conditions

Refrigerated plasma or plasma collected in citrate, heparin, or oxalate. Grossly hemolyzed specimens.

Remarks
Stability

Serum: Ambient: 8 hours; Refrigerated: 5 days; Frozen: 1 month
Plasma: Ambient: 8 hours; Refrigerated: Unacceptable; Frozen: 1 month

Reference Interval

Test Number
Components
Reference Interval
  Aldosterone
Age
Posture Unspecified (ng/dL)
Supine (ng/dL)
Upright (ng/dL)
0-6 days 5.0-102.0
1-3 weeks 6.0-179.0
1-11 months 7.0-99.0
1-2 years 7.0-93.0
3-10 years 4.0-44.0
11-14 years 4.0-31.0
15 years and older 31.0 or less 16.0 or less 4.0-31.0

  Direct Renin
Age Upright (pg/mL) Supine (pg/mL)
Less than or equal to 40 years 4.2-52.2 3.2-33.2
Greater than 40 years 3.6-81.6 2.5-45.1

  Aldosterone/Direct Renin Calculation 0.1-3.7

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.

Compliance Category

FDA

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.

Hotline History

N/A

CPT Codes

82088; 84244

Components

Component Test Code* Component Chart Name LOINC
0070015 Aldosterone 1763-2
2001576 Direct Renin 35570-1
2002583 Aldosterone/Direct Renin Calculation 30894-0
* 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
Aldosterone and Renin, Direct with Ratio