Laboratory Lab results are too important to go anywhere else.

Aldosterone and Direct Renin, Ratio

Test Codes

EPIC: LAB1230661

Department

Immunology

Instructions

Patient preparation prior to specimen collection:

• Angiotensin Converting Enzyme (ACE) Inhibitors should be avoided, if possible, for at least 48 hours prior to collection.
• Sprironlactone (Aldactone) should be discontinued 4-6 weeks prior to testing.
• Patient should be on a normal sodium diet.

Specimen Collection Criteria

Collect: One Lavender-top EDTA tubes.

Critical frozen. Immediately deliver to the Laboratory for processing. Separate specimens must be submitted when multiple tests are ordered.

DO NOT put the specimen on ice or in the fridge. 

Physician Office/Draw Specimen Preparation

Critical frozen. Centrifuge to separate plasma from cells. Transfer plasma to a plastic transport tube and freeze (-20°C/-4°F or below) immediately.

DO NOT put the specimen on ice or in the fridge.

Preparation for Courier Transport

Transport: 1.5 mL plasma, frozen (-20°C/-4°F or below). (Minimum: 1.0 mL)

Rejection Criteria

• Grossly icteric specimens.
• Grossly lipemic specimens.
• Hemolyzed specimens.
• Heparin plasma specimens.
• Serum specimens.
• Specimens not collected and processed as indicated.
• Dark blue trace element EDTA.
• Non-frozen samples.

In-Lab Processing

Critical frozen. Centrifuge to separate plasma from cells. Transfer plasma to a plastic transport tube and freeze (-20°C/-4°F or below) immediately.

Transport: 1.5 mL plasma, frozen (-20°C/-4°F or below). (Minimum: 1.0 mL)

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): 30 days

Specimen Storage in Department Prior to Disposal:

Specimens are kept frozen (-20°C/-4°F or below): 7 days

Laboratory

Royal Oak Special Chemistry Laboratory

Performed

Tuesday and Saturday.
Results available in 1-5 days.

Test Methodology

Chemiluminescence.

Interpretation

Aldosterone:

Aldosterone concentration is affected by posture prior to blood collection and sodium intake. High sodium intake tends to suppress aldosterone, whereas low sodium intake will elevate aldosterone. The references intervals are based on normal intake. 

Posture	Aldosterone (ng/dL)
Upright	4.0-31.0
Supine	≤ 16.0
Unspecified	≤ 31.0

Direct Renin:

Direct Renin concentration is affected by posture prior to blood collection

Posture	Age	Renin, Direct (pg/mL)
Upright	≤ 40	4.2-52.2
Upright	> 40	3.6-81.6
Supine	≤ 40	3.3-33.2
Supine	> 40	2.5-45.1

Aldosterone and Direct Renin Ratio:

The report for this test will include aldosterone & renin measurements, along with the calculated ratio. A ratio greater than 3.7 is considered abnormal and suggestive of primary hyperaldosteronism.

Clinical Utility

Aldosterone and Direct Renin measurements are intended for use in the diagnosis of primary aldosteronism. Calculating the ratio of aldosterone to direct renin is preferred when screening for hyperaldosteronism. 

CPT Codes

Aldosterone: 82088
Renin, Direct: 84244

LOINC Codes
Aldosterone: 1768-1
Renin, Direct: 47883-4

Contacts

Last Updated

7/3/2025