Aldosterone

ALD

The Endocrine Society Clinical Practice Guidelines (2008) recommends the following patient groups be investigated for primary hyperladosteronism (PA). 
Patients with (i) moderate, severe or drug resistant hypertension (ii) hypertension and hypokalemia  (iii) hypertension with adrenal incidentaloma (iv) hypertension and a family history of early onset hypertension or cerebrovascular accident at an early age (<40 years). 
The only form of secondary hyperaldosteronism in which the assay of aldosterone is of value is Bartter's syndrome (not in nephrotic syndrome, cirrhosis etc). 
Measurement of PRA may assist management. IF RENIN ALSO REQUESTED BOOK IN AS CONN.

Include blood pressure and drugs.

After overnight recumbency: 
100 - 450 pmol/L. 
Random sample on upright patient: 
100 - 800 pmol/L

Plasma (or serum)

Lithium heparin (EDTA acceptable) STT if only for aldosterone

700 uL

4 weeks

4 weeks

Dept of Clinical Biochemistry, Charing Cross Hospital