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Test Code LAB9148 Aldosterone, Right Adrenal Vein, Plasma

Additional Codes

APRAV


Specimen Required


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

Supplies: Sarstedt Aliquot Tube, 5 mL (T914)

Collection Container/Tube: Lavender top (EDTA)

Submission Container/Tube: Plastic vial

Specimen Volume: 1.6 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 plasma into a plastic vial.


Secondary ID

65426

Useful For

Investigation using right adrenal vein plasma 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)

Method Name

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

Specimen Type

Plasma EDTA

Specimen Minimum Volume

1 mL

Specimen Stability Information

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

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

Reference Values

No established reference values.

Interpretation

A high ratio of plasma aldosterone (PA) 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. A PA:PRA ratio of 20 or greater is only interpretable with a PA of 15 ng/dL or greater 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; 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;252[2]:308-313)

Day(s) Performed

Monday through Friday

Report Available

2 to 5 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

82088

LOINC Code Information

Test ID Test Order Name Order LOINC Value
APRAV Aldosterone, RAV, P 1763-2

 

Result ID Test Result Name Result LOINC Value
65426 Aldosterone, RAV, P 1763-2