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  Aldosterone and Renin Direct, With Ratio

ALD/DR
Example Reports
Abnormal
Normal

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Additional Technical Information

Ordering Recommendation

Use to screen for and diagnose hyperaldosteronism.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

  Blood should be obtained in seated position in the morning without venous stasis (release tourniquet after venipuncture and wait at least 5 seconds before withdrawing blood). If the patient is supine, ensure that the patient is in this position for at least 30 minutes prior to collection.

Collect

  Serum separator tube (SST) AND lavender (EDTA). Do not collect in refrigerated tubes nor store tubes on ice.

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 at refrigerated temperatures may cause falsely elevated results. Do not collect in refrigerated tubes. Process blood at room temperature and centrifuge tubes in a nonrefrigerated centrifuge.

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

  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

Methodology

Qualitative Chemiluminescent Immunoassay (CLIA)

Performed

Mon, Wed, Fri

Reported

1-5 days

Reference Interval
Test Number
 Components
 Reference Interval
  Aldosterone/Direct Renin Calculation Less than or equal to 4.0

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

View Hotline History

 

Hotline History

Date of Change
Test Name Change
Methodology
Performance/Reported Schedule
Specimen Requirements
Reference Interval
Interpretive Data
Note
CPT Code
Component Change
Other Interface Change
New Test
Inactive
04/20/2026
X
X
N/A

CPT Codes

Refer to Aldosterone (0070015) and Renin, Direct (2001575)

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Components

Component Test Code* Component Chart Name LOINC
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
  • ARR
  • ARR-D
  • DRA
  • Renin direct
Aldosterone and Renin Direct, With Ratio