Test library
Aldosterone Renin Ratio Test
The aldosterone-to-renin ratio test compares aldosterone and renin levels in the blood to screen for primary aldosteronism, a hormonal cause of high blood pressure. It is often ordered when blood pressure is hard to control.
Order Aldosterone-to-Renin Ratio Test
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Order Aldosterone-to-Renin Ratio Test- Typical turnaround
- 1-3 business days
- Starting price
- From $149
- Results
- Confidential, online
Quick answer
The aldosterone-to-renin ratio test measures aldosterone and renin in the same blood sample and compares them. Aldosterone helps regulate sodium, potassium, and blood pressure, while renin is the enzyme that normally controls aldosterone release. When aldosterone is high while renin stays low, the pattern can point to a hormonal cause of hypertension that deserves further evaluation.
What this test measures
Aldosterone is produced by the adrenal glands and acts on the kidneys to retain sodium and excrete potassium, which raises blood pressure. Renin, made by the kidneys, is part of the system that stimulates aldosterone when blood pressure or sodium levels fall. The ratio between the two hormones reveals whether aldosterone production is behaving appropriately for the body's signals.
The test is most often requested for people whose blood pressure remains high despite multiple therapies, who have low potassium, or who have an adrenal nodule discovered on imaging. Because aldosterone and renin fluctuate with posture, time of day, and other factors, laboratories standardize collection conditions and may repeat abnormal results.
An elevated ratio is a screening finding, not a diagnosis. Confirmatory testing is usually required before a treatment plan is made. Clinicians also consider medications, potassium levels, and kidney function because all of these can influence aldosterone and renin measurements.
- Plasma aldosterone concentration (PAC)
- Plasma renin activity (PRA)
- Direct renin concentration (DRC)
- Aldosterone-to-renin ratio (ARR)
- Serum potassium
- Serum sodium
- Serum cortisol, when ordered together
Why people order this test
- Evaluate high blood pressure that is difficult to control
- Investigate low potassium together with hypertension
- Assess an adrenal nodule found on imaging
- Screen for primary aldosteronism before considering other explanations
- Follow up on an abnormal aldosterone or renin result
- Clarify possible secondary causes of hypertension with a provider
How to prepare
Collection timing and body position can affect aldosterone and renin, so the laboratory may ask for a morning draw and a period of rest before sampling. Fasting may also be requested. Discuss current medications with the ordering provider, since some can influence the results.
Understanding your results
Results are usually available within one to three business days. The report includes aldosterone, renin, and the calculated ratio. An elevated ratio may prompt confirmatory testing; only a qualified healthcare provider can interpret the result and decide on next steps.
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Frequently Asked Questions
What is primary aldosteronism?
It is a condition in which the adrenal glands produce too much aldosterone, leading to sodium retention, potassium loss, and high blood pressure.
Why measure renin along with aldosterone?
Renin shows whether the body is signaling for more aldosterone. Comparing the two helps identify an inappropriate aldosterone level.
How should I prepare for the test?
The laboratory may specify a morning collection time and a period of rest before the draw. Follow the instructions supplied with the order.
Can medications affect the ratio?
Yes. Several medications can change aldosterone or renin levels, so the ordering provider should review a complete medication list before interpreting results.
Does an elevated ratio confirm a diagnosis?
No. It is a screening result. Confirmatory testing is typically needed before a diagnosis is made.
Ready to get tested?
Order online and visit a collection site near you, or choose a mail-in kit. No referral and no insurance required.
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