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Renin Activity

Test Background

Renin is an aspartyl protease enzyme secreted by the juxto-glomerular cells located in the afferent arterioles of the kidney. It is important in control of production of angiotensin II, a vasoactive peptide that is the principal regulator, along with potassium, of aldosterone release from the adrenal glands. Renin activity is the predominant regulator of aldosterone synthesis and secretion

Clinical Indications

Diagnosis of and differentiation between primary and secondary hyper- and hypo-aldosteronism
Monitoring mineralocorticoid replacement therapy
Management of renal artery stenosis (RAS)
Diagnosis and location of renin-secreting tumours

Reference Range

Less than six years = appropriate range will be given with the test results
Adult (random) = 0.5-3.5 nmol/L/h
Aldosterone to renin ratio used in clinical context to support/exclude diagnosis of primary hyperaldosteronism

Sample volume
800 uL ideal for paired renin & aldosterone but smaller samples accepted and run at dilution particularly in paediatrics/neonates
Turnaround time
4 weeks
Sample & Container Required
EDTA plasma preferred, heparin plasma also accepted; Samples should ideally be separated and frozen within 60 mins but must be separated within 4 hours.
Sample Collection

Do not collect on ice or separate in a chilled centrifuge.

Transport Storage
Store frozen and send frozen
Notes

The aldosterone renin ratio is used in the clinical context to support/exclude diagnosis of primary hyperaldosteronism. For primary hyperaldosteronism, correct severe hypokalaemia (plasma potassium should be ≥ 3.0 mmol/L). Patients must be receiving an adequate intake of both sodium (100-150 mmol/24 h) and potassium (50-100 mmol/24 h) and discontinue the supplementation temporarily for 24 hours before blood samples are taken. All interfering drugs should be discontinued if at all possible for a minimum of 2 weeks (aldosterone antagonists for 6 weeks). If not possible, antihypertensive drugs may be continued for an initial screening sample with the exception of spironolactone and oestrogen (stop for at least 4 weeks), β-blockers and NSAIDs (stop for at least 1 week).

 

Rejection Criteria: Collected on ice. Serum sample. Not handled appropriately.

UKAS accreditation issue number 023, issue date 03.05.2024. Renin activity is mentioned within the scope as accredited for CXH on pg.15.

Record last updated
August 27, 2025

Sample Container

4ml EDTA Vacutainers (Lavender top)

Sample Container

6ml Lithium Heparin (Green top)

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Test Results

Yes, we have a Pathology User Guide

Yes. Please email your request to Imperial.nwlpcustomerservice@nhs.net

Results are communicated to clinical staff and are normally not communicated direct to patients either on telephone requests or in written report. If you need to contact us please click here to view the contact details page

Please contact the Customer Service Team Monday to Friday from 8:30am – 6:00pm on 0203 313 5353. Alternatively, see the Pathology User Guide for how to contact the relevant department. If advice is not urgent you can also email your query to Imperial.nwlpcustomerservice@nhs.net

Additional tests may be added by discussion with the relevant laboratory. The time limit for adding additional tests to a sample already received in the laboratory will depend on the type of sample and the department it was sent to.

Information on the repertoire of tests performed by pathology, including reference ranges, turnaround times and specimen requirements, can be found in the test directory.

NWLP operates UKAS accredited medical laboratories as per the references below. The current scope of accreditation for all NWLP’s laboratories can be found on the UKAS website.

See the following UKAS ref numbers:

  • Clinical Biochemistry Ref: 8673
  • Haematology and Blood Transfusion Ref: 8674
  • Infection & Immunity Sciences (Including Immunology, Virology, Microbiology and Histocompatibility and Immunogenetics ) Ref: 8659
  • Cellular Pathology (Including Histopathology, Cytology and Molecular Pathology) Ref: 9615

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UKAS requires the laboratories to be accredited for a particular repertoire/scope (ISO15189), any changes or additions to repertoire require assessment by UKAS (extension to scope).

The BD Hospital Tube GuideBD GP Tube Guide and BD Paediatric Tube Guide provide visual references to the correct tube types and collection instructions.

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VIDEO ON BLOOD SAMPLE COLLECTION (without subtitles)

VIDEO ON BLOOD SAMPLE COLLECTION (with subtitles)

Our accreditations

Upholding excellence in diagnostic standards

Our laboratories are accredited by the UK Accreditation Service (UKAS) against the international standard ISO15189:2022. UKAS is the accreditation body for the UK that assesses medical laboratories.

Find out more about our accreditations on the UKAS website.

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