Test Catalog

Test Id : ALDNA

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Aldosterone with Sodium, 24 Hour, Urine

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

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
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

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

Method Name
A short description of the method used to perform the test

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

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

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Aldosterone with Sodium, Urine

Aliases
Lists additional common names for a test, as an aid in searching

Sodium (Na)

Specimen Type
Describes the specimen type validated for testing

Urine

Necessary Information

24-Hour volume (in milliliters) is required.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
TM47 Collection Duration (h)
TM11 Collection Duration
VL45 Volume (mL)
VL9 Urine Volume

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

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.

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Urine Preservative Collection Options

Note: The addition of preservative must occur prior to beginning the collection.

Ambient (no additive)

No

Refrigerate (no additive)

No

Frozen (no additive)

No

50% Acetic Acid

Preferred

Boric Acid

OK

Diazolidinyl Urea

No

6M Hydrochloric Acid

No

6M Nitric Acid

No

Sodium Carbonate

No

Thymol

No

Toluene

No

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

2 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
Frozen 14 days
Ambient 7 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

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

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

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 can stimulate aldosterone secretion.

 

Urinary aldosterone levels are inversely correlated with urinary sodium excretion. Normal individuals will show a suppression of urinary aldosterone with adequate sodium repletion.

 

Primary hyperaldosteronism, which may be caused by aldosterone-secreting adrenal adenoma/carcinomas or adrenal cortical hyperplasia, is characterized by hypertension accompanied by increased aldosterone levels, hypernatremia, and hypokalemia. Secondary hyperaldosteronism (eg, in response to renovascular disease, salt depletion, potassium loading, cardiac failure with ascites, pregnancy, Bartter syndrome) is characterized by increased aldosterone levels and increased plasma rennin activity.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

ALDOSTERONE

0-30 days: 0.7-11.0 mcg/24 h*

1-11 months: 0.7-22.0 mcg/24 h*

> or =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.

Interpretation
Provides information to assist in interpretation of the test results

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.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

Angiotensin converting enzyme (ACE) inhibitors have the potential to "falsely elevate" plasma renin activity (PRA). Therefore, in a patient treated with an ACE-inhibitor, the findings of a detectable PRA level or a low sodium aldosterone/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.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

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

Method Description
Describes how the test is performed and provides a method-specific reference

Sodium:

The ion selective electron (ISE) module indirectly measures the electromotive force (EMF) difference between an ISE and a reference electrode. The EMF of the ISE is dependent on the ion concentration of the sample. The EMF of the reference electrode is constant. An electronic calculation circuit converts EMF of the sample to the ion concentration of the sample.(Package insert: ISE indirect Na, K, Cl for Gen 2. Roche Diagnostics; V14.0, 02/2018)

 

Aldosterone:

Samples are spiked with deuterated internal standard and are hydrolyzed overnight with acid. Samples are then neutralized and extracted by solid phase extraction. The extracts are dried, reconstituted, and analyzed by liquid chromatography tandem mass spectrometry.(Taylor RL, Singh RJ. Validation of liquid chromatography-tandem mass spectrometry method for analysis of urinary conjugated metanephrine and normetanephrine for screening of pheochromocytoma. Clin Chem. 2002;48[3]:533-539; Wurth R, Tirosh A, Kamilaris CDC, et al. Volumetric modeling of adrenal gland size in primary bilateral macronodular adrenocortical hyperplasia. J Endocr Soc. 202029;5[1]:bvaa162)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Tuesday, Thursday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 8 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

See Individual Unit Codes

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

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
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

82088-Aldosterone

84300-Sodium

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
ALDNA Aldosterone with Sodium, Urine 94871-1
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
8556 Aldosterone, U 1765-7
TM47 Collection Duration (h) 13362-9
VL45 Volume (mL) 3167-4
NA_24 Sodium, 24 HR, U 2956-1
TM11 Collection Duration 13362-9
VL9 Urine Volume 3167-4
NACN Sodium Concentration 21525-1

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports

Test Update Resources

Change Type Effective Date
File Definition - Result ID 2024-10-22