Centrifuge, separate, and freeze at -20 ºC. Serum may be stored at 2-8 ºC for 7 days, or up to 2 months at -20 ºC.
Primary hyperaldosteronism is caused by the overproduction of aldosterone by the cortex of the adrenal glands, (due to the presence of an adrenal adenoma or adrenal hyperplasia). The high aldosterone level increases the reabsorption of sodium and the loss of potassium by the kidneys, resulting in an electrolyte imbalance. Symptoms are not typically present, although muscle weakness can occur if potassium levels are very low.
The presence of hypokalaemia in a person with hypertension suggests the need to look for hyperaldosteronism.
Secondary hyperaldosteronism, which is more common, is a result of anything that increases renin levels, such as decreased blood flow to the kidneys, decreased blood pressure, or low sodium levels. The most important cause is narrowing of the blood vessels that supply the kidney, termed renal artery stenosis. Secondary hyperaldosteronism may also be seen with congestive heart failure, cirrhosis, kidney disease, and toxaemia of pregnancy.
Hypoaldosteronism (decreased production) usually occurs as part of adrenal insufficiency; it causes dehydration, low blood pressure, hyperkalaemia and hyponatraemia.
For a supine sample: patient must be recumbant for 15 min prior to withdrawal of specimen.
For a standing sample: patient should be ambulatory for at least 15 mins.
Patient should preferably be off diuretic therapy and volume replete. The sample does not need to be taken whilst the patient is fasting.
A full list of drug interactions can be found here http://emedicine.medscape.com/article/920713-workup
Patient should be on a normal diet, on a low sodium diet the aldosterone could be 2-5 times that of normal.
When sent from other hospitals serum/plasma should be sent frozen but if it arrives thawed it can still be done unless it takes > 2 weeks to arrive.
Fludrocortisone does not cross-react in the assay.
Aldosterone levels fall to very low levels with severe illness, so testing should not be done at times when a person is very ill. Stress and strenuous exercise can temporarily increase aldosterone results.
The general investigation of the aldosterone:renin axis sometimes involves the use of posture studies.
For recumbant samples, the patient should be lying down for at least 15 minutes; for standing samples, patients should remain upright for at 15 minutes.
To convert from conventional units to SI units, multiply SA (ng/dL)×27.743=pmol/L.
From 20.08.15 we now accept EDTA plasma samples aswell as SST serum samples for aldosterone analysis.
Recumbant: 28-445 pmol/L. Standing: 110-860 pmol/L
For paediatric ranges (from http://hyper.ahajournals.org/content/56/3/391.full)
95th Percentile = 491 pmol/L
5th Percentile = 69 pmol/L
Please note change in reference range from 01/03/2018:
Standing <750pmol/L (provided by referral lab)
UK NEQAS for Steroid Hormones scheme
Copyright heftpathology 2013, 2014, 2015, 2016, 2017, 2018
HTA licence number is 12366
Protection of Personal Information – Laboratory Medicine comply with the Trust Data Protection Policy and have procedures in place to allow the Directorate and it’s employees to comply with the Data Protection Act 1998 and associated best practice and guidance.
The Trust Laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital were awarded UKAS (United Kingdom Accreditation Service) accreditation to the internationally recognised ISO 15189 standard in May 2015. For a list of accredited tests and other information please visit the test database http://www.heftpathology.com/frontpage/test-database.html.
Tests not appearing on this scope are either under consideration or in the process of accreditation and so currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.
For further information contact Louise Fallon, Quality Manager, 0121 424 1235