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Latest Edit: Hector 2014-03-21 (EDT)

See Also Lab Tests

This test is used to diagnose hyperaldosteronism. A plasma renin assay may be conducted simultaneously, in order to differentiate primary aldosteronism (adrenal pathology) from secondary aldosteronism (extra-adrenal pathology).[1]


  • Aldosterone is a hormone produced by the adrenal cortex and its production is regulated by the renin-angiotensin system.
  • Aldosterone is also stimulated by ACTH, low serum sodium levels, and high serum potassium levels.
  • In turn, aldosterone stimulates the renal tubules of the kidney to absorb sodium and to secrete potassium in the urine, thereby regulating serum sodium and potassium levels.
  • Aldosterone also partially regulates water absorption, since water follows sodium transport.

Patient Preparation

  • No fasting required.
  • Factors which can cause increased levels
  • Strenuous exercise, stress
  • Drugs: diazoxide (Hyperstat), hydralazine (Apresoline), nitroprusside (Nipride), diuretics, laxatives, potassium, and spironolactone.
  • Factors which can cause decreased levels
  • Excessive licorice ingestion
  • Drugs: fludrocortisone (Florinef), propranolol (Inderal), and angiotensin-converting enzyme inhibitors (e.g. captopril), and licorice

Clinical Implications

High levels indicate:

Primary Aldosteronism:

  • Aldosterone-producing adrenal adenoma (Conn disease)
  • Adrenal cortical nodular hyperplasia
  • Bartter's syndrome

Secondary Aldosteronism:

  • Hyponatremia
  • Hyperkalemia
  • Diuretic ingestion resulting in hypovolemia and hyponatremia
  • Laxative abuse
  • Stress
  • Malignant hypertension
  • Poor perfusion states (e.g. congestive heart failure)
  • Decreased intravascular volume (e.g. cirrhosis, nephrotic syndrome)
  • Renal arterial stenosis
  • Pregnancy and oral contraception
  • Hypovolemia or hemorrhage
  • Cushing's disease

Low levels indicate:

  • Aldosterone deficiency
  • Renin deficiency
  • Steroid therapy
  • Addison's disease
  • Patients on high-sodium diet
  • Hypernatremia
  • Toxemia of pregnancy
  • Antihypertensive therapy

Associated Tests


  1. Pagana Kathleen D, Pagana Timothy J (2006) Mosby's Manual of Diagnostic and Laboratory Tests, Mosby.