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Epic Code LAB1230656 Aldosterone

Important Note

4/11/2024 - This test will be performed at Mayo Clnic Laboratory due to reagent shortage.

Additional collection  information: Mayo Clinic Lab

 

Link: Adrenal Vein Specimen Instructions

Interface Order Alias

1230656

Quick Collect

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Clinical Information

Aldosterone plays a primary role in the regulation of sodium and potassium balance in the blood.  Also, aldosterone is used in the diagnosis and treatment of primary aldosteronism, hypertension cause by primary aldosteronism, selective hyperaldosteronism, edematous and other conditions of electrolyte balance.

Icons & Photos

N/A

Collection Instructions

Specimen Collection: Blood

 

Container(s): EDTA Lavender Tube

Preferred Volume to Collect: 3 mL

Minimum Volume to Collect: 2 mL

Neonate Volume to Collect: 2 mL

Capillary collect ok? No

Microtainer acceptable: No

 

Suggested Collection Instructions:

  1. Collect midmorning after the patient has been sitting, standing, or walking for at least 2 hours.
  2. Allow patient to sit 5-15 minutes prior to the draw.
  3. Avoid fist clenching and wait at least 5 seconds after the tourniquet release (if used) to insert the needle.
  4. Collect slowly with a syringe and needle. 
  5. Preferably do not use a Vacutainer to minimize the risk of spuriously raising potassium.
  6. Collect blood carefully, avoiding stasis and hemolysis.
  7. Invert tube gently 8 to 10 times.
  8. Maintain sample in Lavender EDTA at room temperature (ambient), never refrigerate.
  9. Specimen should be processed (aliquoted) within 30 minutes. See Processing Instructions below. Aliquot should be frozen.

 

Processing Instructions (Laboratory, Outpatient or Off-site collection)

  • Processed Specimen: Plasma
  • Centrifuge/Spin: Yes
  • Aliquot: Yes
  • Processed Minimum Volume: 1 mL
  • Processing Instructions:

    • Centrifuge after collection.
    • Reject if plasma is hemolyzed.
    • Within 30 minutes aliquot plasma into a plastic transport tube and freeze immediately.
  • Transport Temperature: Frozen

Rejection Criteria

  • Specimen not centrifuged within 30 minutes after collection.
  • Plasma hemolyzed.
  • Centrifuged plasma not meeting specimen stability requirements.

Specimen Stability

Plasma

  • Ambient: not applicable
  • Refrigerated: 24 hours
  • Frozen:  28 days
  • Laboratory Retention:  7 days

Test Frequency

Available Monday and Thursday, usual turn-around time 1-5 days.

Reference Range

Male and Female: <31.0 ng/dL

 Please see Critical Values Table

Performing Department

Immunochemistry

Performing Department Laboratory Location

Corewell Health Reference Laboratory, Grand Rapids, MI

Methodology

Chemiluminescence

CPT

82088

CDM Code

3008208803

Epic Test ID

1230102272

LOINC

Result name: 1763-2

Additional Information

Suggested Steps to Prepare Patient for Aldosterone-Direct Renin Ratio (ARR) Testing a:

  1. Attempt to correct hypokalemia.
  2. A plasma concentration of [K+] 4.0 mmol/L is the goal for supplementation.
  3. Encourage patient to liberalize (rather than restrict) sodium intake.
  4. Withdraw agents that markedly affect the ARR for at least 4 weeks.
    1. Spironolactone, eplerenone, amiloride, and triamterene
    2. Potassium-wasting diuretics
    3. Products derived from licorice root (eg, licorice, chewing tobacco)
  5. If the results of ARR after discontinuation of the above agents are not diagnostic, and if hypertension can be controlled with relatively noninterfering medications (see Medication table in Lab Catalog), withdraw other medications that may affect the ARR for at least 2 weeks and retest
  1. β-adrenergic blockers, central α2-agonists (eg, clonidine, α-methyldopa), and nonsteroidal anti-inflammatory drugs
  2. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, renin inhibitors, and dihydropyridine calcium channel antagonists
  1. If necessary to maintain hypertension control, commence other antihypertensive medications that have lesser effects on the ARR.  See Medication table in Lab Catalog.
  2. Establish oral contraceptive (OC) and hormone replacement therapy (HRT) status prior to testing because estrogen-containing medications may lower the direct renin concentration (DRC) and cause false-positive ARR when DRC is measured.  Do not withdraw OC unless confident of alternative effective contraception.  Recommend ordering the send-out test “Renin Activity, Plasma” (LAB532) for these patients.

a  Adapted from Funder JW et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Guideline. J Clin Endocrinol Metab, 2016 May, 101(5): 1889-916.

Reviewed Date

12/13/2022