Aldosterone/Direct Renin Ratio

Test Mnemonic


CPT Codes

  • 84244 - QTY (1)
  • 82088 - QTY (1)


  • Aldosterone
  • Renin

Performing Laboratory

Cleveland Clinic Laboratories

Specimen Requirements

Volume Type Container Collect Temperature Transport Temperature Special Instructions
2 mLPlasmaEDTA (Lavender)AmbientFrozen, CriticalCentrifuge and remove plasma from cells within 4 hours of collection. Freeze plasma immediately after separation from cells.


Environmental Condition Description
Frozen30 days

Days Performed

Mon - Fri

Turnaround Time

2 - 7 days


Name Description
Chemiluminescence Immunoassay (CLIA) 

Reference Range

Aldos/Renin Ratio
Sex Age From Age To Type Range Range Unit
Aldosterone, Plasma
Sex Age From Age To Type Range Range Unit
 1 Months12 MonthsNormal5.8 - 110.0ng/dL
 1 Years5 YearsNormal< 36.0ng/dL
 6 Years9 YearsNormal< 24.0ng/dL
 10 Years11 YearsNormal< 15.0ng/dL
 12 Years14 YearsNormal< 22.0ng/dL
 15 Years17 YearsNormal3.0 - 32.0ng/dL
 18 Years99 YearsNormal3.1 - 35.4ng/dL
       0 - 30 Days: Not established 
Direct Renin
Sex Age From Age To Type Range Range Unit
   Years40 YearsNormalUpright: 4.2-52.2pg/mL
 41 Years99 YearsNormalUpright: 3.6-81.6pg/mL
   Years40 YearsNormalSupine: 3.2-33.2pg/mL
 41 Years99 YearsNormalSupine: 2.5-45.1pg/mL

Special Info

Fasting specimens are recommended but not required. Record the time of day and patient's posture during blood collection (supine or upright). DO NOT pre-chill collection tubes, store tubes on ice or refrigerate; cryoactivation of prorenin occurs when samples are refrigerated. Biotin levels of up to 100 mg/day have not shown interference with this assay. Patients taking >100 mg/day to 300 mg/day should refrain from taking Biotin for 1 hour prior to sample collection. Patients taking a Biotin dose >300 mg/day should consult with their physician or the laboratory prior to having a sample taken. Clinicians should consider biotin interference as a source of error, when clinically suspicious of the laboratory result.

Clinical Info

Diagnosis of disorders of the renin-angiotensin-aldosterone system. An increased Aldo/Renin ratio is suggestive, but not diagnostic of primary aldosteronism if aldosterone concentration is > 15 ng/dL. Normal serum levels of aldosterone are dependent on the sodium intake and whether the patient is upright or supine. High sodium intake will tend to suppress serum aldosterone, whereas low sodium intake will elevate serum aldosterone. The reference interval for serum aldosterone are based on normal sodium intake.

Clinical Limitation

Criteria for Rejection: Refrigerated, grossly hemolyzed, grossly lipemic, and obviously microbially contaminated samples will be rejected. Interfering substances: Prorenin