Sign in →

Test Code LAB557 Aldosterone, Serum

Additional Codes

ALDS

Useful For

Investigating primary aldosteronism (eg, adrenal adenoma/carcinoma and adrenal cortical hyperplasia) and secondary aldosteronism (renovascular disease, salt depletion, potassium loading, cardiac failure with ascites, pregnancy, Bartter syndrome)

Testing Algorithm

For more information see Steroid Pathways

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Patient Preparation: Spironolactone (Aldactone) should be discontinued for 4 to 6 weeks before testing. The plasma renin activity cannot be interpreted if the patient is being treated with spironolactone.

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 1.2 mL

Collection Instructions:

1. See Renin-Aldosterone Studies for detailed instructions.

2. The recommended collection time is 8 a.m., after the patient is active for approximately 2 hours. Try to collect the specimen as close to that time as possible and no later than 10 a.m.

3. Centrifuge and aliquot serum into a plastic vial.


Medical University of South Carolina Note:

On-campus collections: Tube to 99 or deliver to University Extension Hospital Room EH318. Send in plastic vial, Refrigerated.

 

Off-campus collections: Centrifuge and aliquot within 2 hours.Specimen to be stored/transported at Refrigerated temp.

Specimen Minimum Volume

1.2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 28 days
  Frozen  30 days
  Ambient  4 days

Reference Values

0-30 days: 17-154 ng/dL*

31 days-11 months: 6.5-86 ng/dL*

1-10 years:

≤40 ng/dL (supine)*

≤124 ng/dL (upright)*

≥11 years: ≤21 ng/dL (a.m. peripheral vein specimen)

 

*Loeuille GA, Racadot A, Vasseur P, Vandewalle B: Blood and urinary aldosterone levels in normal neonates, infants and children. Pediatrie 1981 Jul-Aug;36(5):335-344

 

For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html

Day(s) Performed

Monday through Friday

CPT Code Information

82088

LOINC Code Information

Test ID Test Order Name Order LOINC Value
ALDS Aldosterone, S 1763-2

 

Result ID Test Result Name Result LOINC Value
8557 Aldosterone, S 1763-2

Interpretation

A high ratio of serum aldosterone (SA) in ng/dL to plasma renin activity (PRA) in ng/mL per hour, is a positive screening test result, a finding that warrants further testing. An SA/PRA ratio greater than or equal to 20 is only interpretable with an SA greater than or equal to 15 ng/dL and indicates probable primary aldosteronism.

 

Kidney disease, such as unilateral renal artery stenosis, results in elevated renin and aldosterone levels. Renal venous catheterization may be helpful. A positive test is a renal venous renin ratio (affected/normal) greater than 1.5.

 

Note: Advice on stimulation or suppression tests is available from Mayo Clinic's Division of Endocrinology; call 800-533-1710.

Method Description

Aldosterone-d6 is added to serum and plasma samples as an internal standard. Aldosterone and aldosterone-d6 are extracted from the specimens using a Strata X cartridge. The eluate is dried down under nitrogen, reconstituted with 70/30 methanol/water containing estriol and analyzed by liquid chromatography tandem mass spectrometry using multiple reaction monitoring in the negative mode.(Fredline VF, Taylor PJ, Dodds HM, Johnson AG: A reference method for the analysis of aldosterone in blood by high-performance liquid chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry. Anal Biochem. 1997 Oct 15;252(2):308-313)

Report Available

2 to 5 days

Specimen Retention Time

14 days

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Method Name

Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Cardiovascular Test Request (T724)

Secondary ID

8557