Aldosterone/Plasma Renin Activity Ratio, LC/MS/MS

The Aldosterone/Plasma Renin Activity Ratio, LC/MS/MS test contains 1 test with 3 biomarkers.

Description: Aldosterone and Renin tests are blood tests often ordered together to test patients with low potassium or high blood pressure.

Also Known As: Aldosterone Test, Renin Test, Aldosterone and Renin Ratio Test, Aldosterone and Renin Activity Test, PRA Test, Plasma Renin Activity Test

Collection Method: Blood Draw

Specimen Type: Plasma

Test Preparation: No preparation required

Average Processing Time: 5 to 6 days

When is an Aldosterone and Plasma Renin Activity test ordered?

When someone has high blood pressure, a blood aldosterone test and a renin test are generally requested together, especially if the person also has low potassium. Even if potassium levels are within normal limits, testing may be necessary if standard drugs fail to control high blood pressure or if hypertension develops at a young age. Because primary aldosteronism is a potentially curable form of hypertension, it’s critical to catch it early and effectively treat it.

When a healthcare practitioner suspects adrenal insufficiency or Addison disease, aldosterone levels, along with additional testing, are occasionally recommended. The aldosterone stimulation test, also known as ACTH stimulation, measures aldosterone and cortisol levels to identify whether a person has Addison disease, reduced pituitary function, or a pituitary tumor. After ACTH stimulation, a natural outcome is an increase in cortisol and an increase in aldosterone.

What does an Aldosterone and Plasma Renin Activity blood test check for?

Aldosterone is a hormone that helps to maintain proper sodium and potassium levels in the circulation as well as regulate blood volume and blood pressure. Renin is an enzyme that regulates the production of aldosterone. The levels of aldosterone and renin in the blood and/or the amount of aldosterone in the urine are measured in these tests.

The adrenal glands, which are positioned on the top and outside portions of each kidney, create aldosterone. Aldosterone increases sodium retention and potassium elimination via the kidneys. Renin is a protein generated by the kidneys that regulates the activity of the hormone angiotensin, which stimulates the production of aldosterone by the adrenal glands.

Renin is released by the kidneys when blood pressure drops or the sodium chloride concentration in the tubules of the kidney decreases. Renin breaks down the blood protein angiotensinogen to produce angiotensin I, which is then transformed to angiotensin II by a second enzyme. Angiotensin II constricts blood vessels and increases the synthesis of aldosterone. Overall, this boosts blood pressure while maintaining appropriate salt and potassium levels.

Aldosterone overproduction or underproduction can be caused by a number of factors. Because renin and aldosterone are so closely associated, they’re frequently examined jointly to figure out what’s causing an aberrant aldosterone level.

Lab tests often ordered with an Aldosterone and Plasma Renin Activity test:

  • Electrolytes
  • Potassium
  • Cortisol
  • Aldosterone
  • Plasma Renin Activity

Conditions where an Aldosterone and Plasma Renin Activity test is recommended:

  • Adrenal Insufficiency
  • Addison Disease
  • Hypertension
  • Endocrine Syndromes
  • Conn Syndrome

How does my health care provider use an Aldosterone and Plasma Renin Activity test?

Aldosterone and renin tests are performed to determine whether the adrenal glands are producing enough aldosterone and to differentiate between potential causes of excess or insufficiency. Aldosterone can be detected in the blood or in a 24-hour urine sample, which determines how much aldosterone is excreted in the urine over the course of a day. Renin is always counted in milligrams per milliliter of blood.

Primary aldosteronism, commonly known as Conn syndrome, is a condition that produces high blood pressure and can be detected with these tests. If the test is positive, stimulation and suppression testing can be used to further examine aldosterone production.

The highest levels of aldosterone and renin are in the morning, and they fluctuate throughout the day. The position of the body, stress, and a number of prescribed medications all have an impact on them.

What do my aldosterone and plasma renin activity test results mean?

Conn syndrome is characterized by the adrenal glands overproducing aldosterone, which is usually caused by a benign tumor in one of the glands. A high aldosterone level causes increased salt reabsorption and potassium loss by the kidneys, resulting in an electrolyte imbalance. High blood pressure, headaches, and muscle weakness are signs and symptoms, especially if potassium levels are very low.

When someone has hypertension and their blood potassium is lower than usual, it's time to look for aldosteronism. Blood is drawn from both of the adrenal veins and tested to see whether there is a difference in the amount of aldosterone produced by both of the adrenal glands to establish whether only one or both are impacted.

Secondary aldosteronism, which is more prevalent than primary aldosteronism, is caused by anything other than an adrenal gland condition that causes excess aldosterone. Any disorder that reduces blood flow to the kidneys, lowers blood pressure, or lowers sodium levels could cause it. Congestive heart failure, liver cirrhosis, kidney illness, and pregnancy toxemia can all cause secondary aldosteronism. It's also typical when you're dehydrated. The cause of aldosteronism is usually clear in these circumstances.

The most common cause of secondary aldosteronism is renal artery stenosis, which is a constriction of the blood arteries that supply the kidney. High renin and aldosterone levels produce high blood pressure, which can be treated with surgery or angioplasty. A catheter is introduced via the groin and blood is collected straight from the veins draining the kidney to see if only one kidney is damaged. If one side's result is much higher than the other, this suggests that the artery is narrowed.

Adrenal insufficiency is the most common cause of low aldosterone. Dehydration, low blood pressure, a low salt level in the blood, and a high potassium level are all symptoms. Congenital adrenal hyperplasia, a disorder in which babies lack an enzyme needed to create cortisol, can reduce aldosterone production in some circumstances.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: AldosteronePlasma Renin Activity Ratio LCMSMS

Aldo/Pra Ratio

Aldosterone, LC/MS/MS

Plasma Renin Activity,

*Process times are an estimate and are not guaranteed. The lab may need additional time due to weather, holidays, confirmation/repeat testing, or equipment maintenance.

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