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Test ID: ALDS Aldosterone, Serum

Reporting Name

Aldosterone, S

Useful For

Investigation of 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)

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 is not a major factor in regulating aldosterone secretion.

 

See Steroid Pathways in Special Instructions.

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.

 

Renal 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.

 

See Renin-Aldosterone Studies and Steroid Pathways in Special Instructions.

 

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.

Testing Algorithm

See Steroid Pathways in Special Instructions.

Analytic Time

2 days

Day(s) and Time(s) Performed

Monday through Friday; 4 p.m.

Clinical Reference

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

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

3. Hurwitz S, Cohen RJ, Williams GH: Diurnal variation of aldosterone and plasma renin activity: timing relation to melatonin and cortisol and consistency after prolonged bed rest. J Appl Physiol. 2004;96:1406-1414

4. Inoue K, Goldwater D, Allison M, Seeman T, Kestenbaum BR, Watson KE: Serum aldosterone concentration, blood pressure, and coronary artery calcium: The Multi-Ethnic Study of Atherosclerosis. Hypertension. 2020;76(1):113-120. doi:10.1161/HYPERTENSIONAHA.120.15006

Method Name

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

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 1.2 mL

Collection Instructions: 8 a.m. collection time (after the patient is active for 2 hours) is recommended; preferably no later than 10 a.m.

Additional Information: See Renin-Aldosterone Studies in Special Instructions for more detailed instructions.


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;36:335-344

 

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

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 U.S. Food and Drug Administration.

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

Forms

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

-General Request (T239)

-Cardiovascular Test Request (T724)

Mayo Clinic Laboratories | Endocrinology Catalog Additional Information:

mml-adrenal-gonad-pituitary