Test Code PALD Aldosterone, Plasma
Specimen Required
Collection Container/Tube: Lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 2 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 plasma into a plastic vial.
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) using plasma specimens
Testing Algorithm
For more information see Steroid Pathways.
Special Instructions
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Aldosterone, PSpecimen Type
Plasma EDTASpecimen Minimum Volume
1.2 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Plasma EDTA | Frozen (preferred) | 30 days | |
Refrigerated | 28 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(5):335-344
For International System of Units (SI) conversion for Reference Values, see www.mayocliniclabs.com/order-tests/si-unit-conversion.html.
Interpretation
A high ratio of plasma aldosterone (PA) 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 PA/PRA ratio greater than or equal to 20 is only interpretable with an PA greater than or equal to 15 ng/dL 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) greater than 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.
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. 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(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. [published correction appears in Hypertension. 2021 Mar 3;77(3):e34]. Hypertension. 2020;76(1):113-120. doi:10.1161/HYPERTENSIONAHA.120.15006
Day(s) Performed
Monday through Friday
Report Available
2 to 5 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterTest 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 |
---|---|---|
PALD | Aldosterone, P | 1763-2 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
65424 | Aldosterone, P | 1763-2 |