Patient Preparation: The plasma renin activity cannot be interpreted if the patient is being treated with spironolactone (Aldactone). Spironolactone should be discontinued for 4 to 6 weeks before testing.
Collection Container/Tube: Chilled, lavender top (EDTA)
Submission Container/Tube: Plastic vial
Specimen Volume: 2 mL
Collection Instructions:
Draw blood in a chilled syringe from a patient in a seated position; place specimenin a chilled, lavender-top (EDTA) tube; and mix
Alternatively, draw blood directly in a chilled, lavender top (EDTA) tube
Immediately place EDTA tube into an ice-water bath until thoroughly cooled
Refrigerate specimen during centrifugation and immediately transfer plasmato plastic vial. (If a refrigerated centrifuge is unavailable, chill the centrifuge carriers. Centrifuge specimen for ≤5 minutes, then promptly transfer plasma.)
Immediately freeze plasma
Minimum Sample Volume
1.15 mL
Stability
Frozen: 14 days
Unacceptable Specimen Conditions
Gross hemolysis
Limitations
Angiotensin converting enzyme (ACE) inhibitors have the potential to "falsely elevate" PRA. Therefore, in a patient treated with an ACE-inhibitor, the findings of a detectable PRA level or a low SA:PRA ratio do not exclude the diagnosis of primary aldosteronism. In addition, a strong predictor for primary aldosteronism is a PRA level undetectably low in a patient taking an ACE-inhibitor.
Methodology
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Estimated TAT
2-5 days
Testing Schedule
Monday through Friday
Retention
14 days
CPT Code(s)
84244
Reference Range
Children: Age (years)
Mean* (ng/mL/hour)
Range (ng/mL/hour)
0-2
4.6
1.4 - 7.8
3-5
2.5
1.5 - 3.5
6-8
1.4
0.8 - 2.0
9-11
1.9
0.9 - 2.9
12-17
1.8
1.2 - 2.4
Adults: Age (years)
Sodium-depleted
Sodium-replete
Sodium-depleted
Sodium-replete
18 - 39
10.8
1.9
2.9 - 24.0
≤0.6 - 4.3
≥ 40
5.9
1.0
2.9 - 10.8
≤0.6 - 3.0
*Mean data not standardized as to time of day or diet. Infants were supine, children sitting, adults were upright (peripheral vein specimens).
