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Aldosterone/Renin Ratio

Source Blood
Mnemonic ALDOS/REN

Order ALDOS/REN if:
1)  Aldosterone and Renin are ordered together, or
2)  Aldosterone/Renin Ratio or PRA Ratio is written on the requisition
 

Prompts:
Position
- Is the patient upright or lying down?  For PSC and outpatients, enter "Upright".
Minutes in Position - How many minutes has the patient been in this position?  For PSC and outpatients, calculate how many minutes the patient has been awake. If patient is unavailable to confirm and if not indicated on requisition, enter "0".

If physician has provided salt intake information or Lasix information, add as an order note.

Both aldosterone and renin will be ordered and must be collected at the same time.


Specimen Requirements Collections performed at acute care (RRL) sites and all PSCs.
Cannot be collected by Mobile Collection Service (MCS).

Collect specimens before 10:00 due to fluctuations in renin levels throughout the day.

Aldosterone  1 x 3.5 mL gold top SST tube
                        1.5 mL serum

Renin              1 x 4 mL lavender top EDTA tube
                         2 x 1.0 mL plasma

Minimum Whole Blood Volumes for Microcollections




Specimen Handling Aldosterone: Use label indicating GOLD SST.
  • PSC & RRL: Centrifuge and transport to DSC.
  • Extra-regional: Centrifuge and transport to DSC.  If specimen will not arrive within 5 days of collection, pour off and freeze.

Renin: Three labels will print; use the 2 labels indicating SEE GTS for the aliquot tubes and the third label for the primary tube.

  • Centrifuge at room temperature or 22oC in a temperature controlled centrifuge within 30 minutes of collection. 
  • Aliquot to two room temperature aliquot tubes and freeze immediately.
  • Transport to DSC frozen, attached to an ice pack or packed in dry ice.   
  • DSC: Place specimens in freezer upon receipt in lab; ensure frozen specimens do not thaw.

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Additional Information
Testing Location Immunochemistry
Testing Frequency Aldosterone - twice a week; Tuesdays and Thursdays.
Renin - twice a week: Tuesdays and Thursdays.
Alternate Name(s) PRA (Plasma Renin Activity), PRA Ratio, Direct Renin Ratio
Reference Interval An aldosterone (pmol/L) / renin concentration (mIU/L) ratio > 60 may be indicative of primary aldosteronism if drawn in the absence of confounding drugs.  Clinical correlation or further investigation may be required for confirmation of this interpretation.