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Test ID: ALDNA Aldosterone with Sodium, 24 Hour, Urine

Reporting Name

Aldosterone with Sodium, Urine

Useful For

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

Clinical Information

Aldosterone stimulates sodium transport across cell membranes, particularly in the distal renal tubule where sodium is exchanged for hydrogen and potassium. Secondarily, aldosterone is important in the maintenance of blood pressure and blood volume.


Aldosterone is the major mineralocorticoid and is produced by the adrenal cortex. The renin-angiotensin system is the primary regulator of the synthesis and secretion of aldosterone. Likewise, increased concentrations of potassium in the plasma may directly stimulate adrenal production of the hormone. Under physiologic conditions, pituitary adrenocorticotropic hormone can stimulate aldosterone secretion.


Urinary aldosterone levels are inversely correlated with urinary sodium excretion. Normal individuals will show a suppression of urinary aldosterone with adequate sodium repletion.


Primary hyperaldosteronism, which may be caused by aldosterone-secreting adrenal adenoma/carcinomas or adrenal cortical hyperplasia, is characterized by hypertension accompanied by increased aldosterone levels, hypernatremia, and hypokalemia. Secondary hyperaldosteronism (eg, in response to renovascular disease, salt depletion, potassium loading, cardiac failure with ascites, pregnancy, Bartter syndrome) is characterized by increased aldosterone levels and increased plasma rennin activity.


Under normal circumstances, if the 24-hour urinary sodium excretion is greater than 200 mEq, the urinary aldosterone excretion should be less than 10 mcg/24 hours.


Urinary aldosterone excretion greater than 12 mcg/24 hours as part of an aldosterone suppression test is consistent with hyperaldosteronism.


Twenty-four-hour urinary sodium excretion should exceed 200 mEq to document adequate sodium repletion.


For more information see Renin-Aldosterone Studies


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

Profile Information

Test ID Reporting Name Available Separately Always Performed
ALDU Aldosterone, U Yes Yes
NAU Sodium, 24 HR, U Yes Yes

Report Available

2 to 8 days

Day(s) Performed

Tuesday, Thursday

Clinical Reference

1. Young WF Jr: Primary aldosteronism: A common and curable form of hypertension. Cardiol Rev. 1999 Jul-Aug;7(4):207-214

2. Young WF Jr: Pheochromocytoma and primary aldosteronism: diagnostic approaches. Endocrinol Metab Clin North Am. 1997 Dec;26(4):801-827

3. 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

4. Carey RM, Padia SH: Primary mineralocorticoid excess disorders and hypertension. In: Jameson JL, De Groot LJ, de Kretser DM, Giudice LC, et al: eds. Endocrinology: Adult and Pediatric. 7th ed. WB Saunders; 2016:1871-1891

Method Name

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

NAU: Potentiometric, Indirect Ion-Selective Electrode (ISE)

Specimen Type


Necessary Information

24-Hour volume is required.

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.

Supplies: Sarstedt Aliquot Tube 5mL (T914)

Container/Tube: 2 Plastic, 5-mL tubes

Specimen Volume: 10 mL

Collection Instructions:

1. Collect urine for 24 hours.

2. Add 25 mL of 50% acetic acid as preservative at start of collection. Use 15 mL of 50% acetic acid for children under the age of 5 years. This preservative is intended to achieve a pH of between approximately 2 and 4.

3. Place 5 mL of well mixed, 24-hour urine in plastic, 5-mL tube and label as Aldosterone.

4. Place 5 mL of well mixed, 24-hour urine in plastic, 5-mL tube and label as Sodium.

Additional Information: See Urine Preservatives-Collection and Transportation for 24-Hour Urine Specimens for multiple collections.

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  14 days
  Ambient  7 days

Reference Values


0-30 days: 0.7-11.0 mcg/24 h*

1-11 months: 0.7-22.0 mcg/24 h*

≥1 year: 2.0-20.0 mcg/24 h


*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



41-227 mmol/24 h

If the 24-hour urinary sodium excretion is greater than200 mmol, the urinary aldosterone excretion should be less than10 mcg.

Test Classification

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information



LOINC Code Information

Test ID Test Order Name Order LOINC Value
ALDNA Aldosterone with Sodium, Urine 94871-1


Result ID Test Result Name Result LOINC Value
NA_24 Sodium, 24 HR, U 2956-1
8556 Aldosterone, U 1765-7
TM47 Collection Duration 13362-9
TM11 Collection Duration 13362-9
VL9 Urine Volume 3167-4
VL45 Urine Volume 3167-4

Urine Preservative Collection Options

Note: The addition of preservative must occur prior to beginning the collection.







50% Acetic Acid


Boric Acid


Diazolidinyl Urea


6M Hydrochloric Acid


6M Nitric Acid


Sodium Carbonate







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