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HelpTest Code Billings Clinic: 8877 Mayo: PRA Renin Activity, Plasma
Reporting Name
Renin Activity, PPerforming Laboratory
Mayo Clinic Laboratories in Rochester
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)
This test is not useful for determination of plasma renin concentration.
Method Name
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Portions of this test are covered by patents held by Quest Diagnostics
Specimen Required
Patient Preparation: For 4 to 6 weeks before specimen collection, spironolactone (Aldactone) should be discontinued, as plasma renin activity cannot be interpreted if the patient is being treated with spironolactone.
Collection Container/Tube: Chilled, lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 0.8 mL
Collection Instructions:
1. Draw blood in a chilled syringe from a patient in a seated position; place specimen in a chilled, 3-mL lavender-top (EDTA) tube and mix well. Alternatively, draw blood directly in a chilled, EDTA tube.
2. Immediately place EDTA tube into an ice-water bath until thoroughly cooled.
3. Immediately centrifuge using a refrigerated centrifuge and aliquot plasma into a plastic vial.
Note: If a refrigerated centrifuge is unavailable, chill the centrifuge carriers before use. Centrifuge specimen for 5 minutes or less, then promptly aliquot plasma into a plastic vial.
4. Immediately freeze plasma.
Specimen Type
Plasma EDTASpecimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Plasma EDTA | Frozen | 14 days |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | OK |
| Gross icterus | OK |
Reference Values
0-2 years: 4.6 ng/mL/h (mean)* Range: 1.4-7.8 ng/mL/h
3-5 years: 2.5 ng/mL/h (mean)* Range: 1.5-3.5 ng/mL/h
6-8 years: 1.4 ng/mL/h (mean)* Range: 0.8-2.0 ng/mL/h
9-11 years: 1.9 ng/mL/h (mean)* Range: 0.9-2.9 ng/mL/h
12-17 years: 1.8 ng/mL/h (mean)* Range: 1.2-2.4 ng/mL/h
Mean data not standardized as to time of day or diet. Infants were supine, children sitting.
*Stalker HP, Holland NH, Kotchen JM, Kotchen TA. Plasma renin activity in healthy children. J Pediatr. 1976;89(2):256-258
Na-depleted, upright (peripheral vein specimen)
18-39 years: 10.8 ng/mL/h (mean)
2.9-24.0 ng/mL/h (range)
≥40 years: 5.9 ng/mL/h (mean)
2.9-10.8 ng/mL/h (range)
Na-replete, upright (peripheral vein specimen)
18-39 years: 1.9 ng/mL/h (mean)
≤0.6-4.3 ng/mL/hour (range)
≥40 years: 1.0 ng/mL/h (mean)
≤0.6-3.0 ng/mL/h (range)
Interpretation
A high ratio of serum aldosterone (SA) in ng/dL to plasma renin activity (PRA) in ng/mL/h, is a positive screening test result, a finding that warrants further testing. A SA:PRA ratio greater than or equal to 20 and SA of greater than or equal to 15 ng/dL indicates probable primary aldosteronism.
Kidney disease, such as unilateral renal artery stenosis, results in elevated renin and aldosterone levels. Kidney venous catheterization may be helpful. A positive test is a renal venous renin ratio (affected:normal) above 1.5.
For more information see Renin-Aldosterone Studies.
Day(s) Performed
Monday through Friday, Sunday
Report Available
2 to 5 daysTest Classification
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
84244
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PRA | Renin Activity, P | 2915-7 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8060 | Renin Activity, P | 2915-7 |
Forms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-General Request (T239)
-Cardiovascular Test Request (T724)