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Test ID: ARAV Aldosterone, Right Adrenal Vein, Serum

Reporting Name

Aldosterone, RAV

Useful For

Investigation using right 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)

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.

 

For more information see Steroid Pathways.

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.

Report Available

2 to 5 days

Day(s) Performed

Monday through Friday

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. 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 Apr;96(4):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 Jul;76(1):113-120. doi: 10.1161/HYPERTENSIONAHA.120.15006. Erratum in: Hypertension. 2021 Mar 3;77(3):e34

Method Name

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

Specimen Type

Serum


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.

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

Reference Values

No established reference values.

Test Classification

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

CPT Code Information

82088

LOINC Code Information

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

 

Result ID Test Result Name Result LOINC Value
6348 Aldosterone, RAV 1763-2
Mayo Clinic Laboratories | Endocrinology Catalog Additional Information:

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