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Test Code 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

Profile Information

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

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Urine


Necessary Information


24-Hour volume (in milliliters) 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. 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.

2. Collect urine for a full 24 hours (required) and record the total volume.

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

ALDOSTERONE

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;36(5):335-344

 

SODIUM

41-227 mmol/24 h

If the 24-hour urinary sodium excretion is greater than 200 mmol, the urinary aldosterone excretion should be less than10 mcg.

Day(s) Performed

Tuesday, Thursday

CPT Code Information

82088-Aldosterone

84300-Sodium

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 (h) 13362-9
TM11 Collection Duration 13362-9
VL9 Urine Volume 3167-4
VL45 Volume (mL) 3167-4

Interpretation

Under normal circumstances, if the 24-hour urinary sodium excretion is greater than 200 mmol, 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 mmol 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.

Clinical Reference

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

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

Report Available

2 to 8 days

Method Name

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

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

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.