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26152 Aldosterone, Serum (ALDS) Test

Aldosterone, Serum (ALDS) Test
Test Code: ALDSSOTEST
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).
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.2 mL ​0.6 mL ​
Collection Processing Instructions
​8 a.m. draw time (after the patient is active for 2 hours) is recommended; preferably no later than 10 a.m.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Refrigerated (preferred) ​28 days
​Frozen ​30 days
​Ambient ​4 days
Interference
​Spironolactone should be discontinued for 4 to 6 weeks before testing.
 
Late p.m. levels can be up to 30% lower than early a.m. levels. Supine values are on average 50% lower than upright collections. Sodium deplete subjects have significantly elevated serum aldosterone (SA) levels, potentially exceeding the upper limit of the salt replete upright reference range by several fold. To account for these variables, at least in part, it is recommended that PRA is measured concomitantly. In situations of physiological variability, PRA should be altered in the same direction as aldosterone. See Renin-Aldosterone Studies in Special Instructions.
 
Angiotensin converting enzyme (ACE) inhibitors have the potential to falsely elevate PRA. Therefore, in a patient treated with an ACE inhibitor, the findings of a detectable PRA level or a low SA/PRA ratio do not exclude the diagnosis of primary aldosteronism. In addition, a strong predictor for primary aldosteronism is a PRA level undetectably low in a patient taking an ACE inhibitor.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories ​Monday through Friday ​2 days ​Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
Mayo Clinic Laboratories
Test Information

This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.   ​

​This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.  
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories ​0-30 days: 17-154 ng/dL*
31 days-11 months: 6.5-86 ng/dL*
1-10 years:
< or =40 ng/dL (supine)*
< or =124 ng/dL (upright)*
> or =11 years: < or =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
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 > or =20 is only interpretable with an SA > or =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) >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 Mayo Medical Laboratories
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82088 ​ ​ ​ ​
Classification

This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.   ​

Ordering Applications
Ordering Application Description
​Centricity ​Aldosterone-Blood
​Cerner ​Aldosterone
​COM ​Aldosterone - Blood
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Fasting Required Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​No ​Serum ​Red Top Tube (RTT) ​Serum Separator Tube (SST) ​1.2 mL ​0.6 mL ​
Collection Processing
​8 a.m. draw time (after the patient is active for 2 hours) is recommended; preferably no later than 10 a.m.
Specimen Stability Information
Specimen Type Temperature Time
​Serum ​ ​ ​Refrigerated (preferred) ​28 days
​Frozen ​30 days
​Ambient ​4 days
Interference
​Spironolactone should be discontinued for 4 to 6 weeks before testing.
 
Late p.m. levels can be up to 30% lower than early a.m. levels. Supine values are on average 50% lower than upright collections. Sodium deplete subjects have significantly elevated serum aldosterone (SA) levels, potentially exceeding the upper limit of the salt replete upright reference range by several fold. To account for these variables, at least in part, it is recommended that PRA is measured concomitantly. In situations of physiological variability, PRA should be altered in the same direction as aldosterone. See Renin-Aldosterone Studies in Special Instructions.
 
Angiotensin converting enzyme (ACE) inhibitors have the potential to falsely elevate PRA. Therefore, in a patient treated with an ACE inhibitor, the findings of a detectable PRA level or a low SA/PRA ratio do not exclude the diagnosis of primary aldosteronism. In addition, a strong predictor for primary aldosteronism is a PRA level undetectably low in a patient taking an ACE inhibitor.
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).
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories ​0-30 days: 17-154 ng/dL*
31 days-11 months: 6.5-86 ng/dL*
1-10 years:
< or =40 ng/dL (supine)*
< or =124 ng/dL (upright)*
> or =11 years: < or =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
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 > or =20 is only interpretable with an SA > or =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) >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 Mayo Medical Laboratories
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories ​Monday through Friday ​2 days ​Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
​82088 ​ ​ ​ ​
Classification

This test should be regarded as 'Research Use Only'. This test has not been cleared or approved by the U.S. Food and Drug Administration. It may not be covered by insurance and providers need to inform all patients of this prior to ordering. 

For Medicare patients, an Advanced Beneficiary notice (ABN) is required; for Medicaid patients, a Noncovered Services Waiver is required, and for commercial payers, prior authorization should be obtained.   ​

For most current information refer to the Marshfield Laboratory online reference manual.