Aldosterone and Renin, Direct with Ratio

2002582
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Abnormal
Normal

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Additional Technical Information
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.
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 collected and 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
0070015 Aldosterone, Serum Effective May 16, 2011
Age
 Posture Unspecified
 Supine
 Upright
0-6 days 5.0-102.0 ng/dL
1-3 weeks 6.0-179.0 ng/dL
1-11 months 7.0-99.0 ng/dL
1-2 years 7.0-93.0 ng/dL
3-10 years 4.0-44.0 ng/dL
11-14 years 4.0-31.0 ng/dL
15 years and older Less than or equal to 31.0 ng/dL Less than or equal to 16.0 ng/dL 4.0-31.0 ng/dL

2001575 Renin, Direct 2.5-45.7 pg/mL
Aldosterone/Direct Renin Calculation 0.1-3.7

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.

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

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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