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HelpTest Code LAB9145 Aldosterone, Left Adrenal Vein, Serum
Additional Codes
ALAV
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
SerumSpecimen 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: 1.8 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.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Serum | Refrigerated (preferred) | 28 days | |
| Frozen | 30 days | ||
| Ambient | 4 days |
Special Instructions
Reference Values
No established reference values.
Day(s) Performed
Monday through Friday
CPT Code Information
82088
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| ALAV | Aldosterone, LAV | 1763-2 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 6349 | Aldosterone, LAV | 1763-2 |
Report Available
2 to 5 daysSpecimen Retention Time
14 daysReject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Useful For
Investigation using left adrenal vein specimen for:
-Primary aldosteronism (eg, adrenal adenoma/carcinoma and adrenal cortical hyperplasia)
-Secondary aldosteronism (renovascular disease, salt depletion, potassium loading, cardiac failure with ascites, pregnancy, Bartter syndrome)
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 of 20 or higher is only interpretable with an SA of 15 ng/dL or higher 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) above 1.5.
Note: Advice on stimulation or suppression tests is available from Mayo Clinic's Division of Endocrinology and may be obtained by calling 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)