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Renin
Also known as : [Active renin],[Plasma renin]


Test performed by: LabPLUS Endocrinology

Specimen Collection

DO NOT STORE OR TRANSPORT AT 4 o C (cryoactivation of prorenin occurs at 4 o C and may lead to a falsely elevated result for renin)

To avoid refrigeration of the sample, it is preferable to not share EDTA samples with Haematology requests.


EDTA

4 mL EDTA Blood (Always Required)

Micro-EDTA

1 mL Paediatric Micro-EDTA Blood (Always Required)
Reference Intervals

Units: mU/L

Paediatric:

< 1 week

0 - 790

1 week - 1 year

7 - 180

1 - 15 years

9 - 134

15 - 18 years

>18 years

9 - 60

4 - 46

Adult:

4 - 46 (sitting)

3 - 40 (supine for 1 hour)

  • The above figures are for average salt intake. At low salt intakes renin levels are increased.
  • Antihypertensive drugs: Diuretics, ACE inhibitors, ARBs, and vasodilators tend to increase renin levels.
  • Beta blockers, clonidine, aldomet, and NSAIDs tend to decrease renin levels.
  • Women using oral contraceptives have lower levels (about half normal).
  • Pregnant women have higher levels (about double normal).
  • High renin levels are seen in heart failure and cirrhosis.


Uncertainty of Measurement: 15%



Turnaround Time: Within 1 week

Performed Weekly.


Assay Method

Principle: Sandwich chemiluminescent immunoassay

Assay: Diasorin

Analyser: Diasorin Liaison


Diagnostic Use and Interpretation

Renin and Aldosterone in Hypertension: The interpretive guide below applies only to patients with hypertension without heart failure, and does not apply to a saline suppression test.

Renin

Aldosterone

Interpretation

<10 >400 Suggestive of primary aldosteronism. A saline suppression test can be done to confirm this. This can be arranged with the Dept. of Endocrinology.
<10 <400 Low-renin, low aldosterone hypertension. Likely to be salt-sensitive and to respond well to diuretic therapy and salt restriction. Consider Liddle's syndrome if hypokalemia is present.
10-60 0-1000 Compatible with essential hypertension.
10-60 >1000 Hyperaldosteronism is present; it is unclear from the renin level whether this is primary or secondary.

>60

>60

0-1000

>1000

Compatible with ACE inhibitor or angiotensin receptor blocker therapy, high renin essential hypertension, or renovascular hypertension.

Suggests secondary hyperaldosteronism. Causes include renovascular disease, malignant hypertension, diuretics, spironolactone


Primary Aldosteronism:

Plasma renin is typically suppressed to less than 10 mU/L in Conn's syndrome, even in the presence of upright posture, diuretics or ACE inhibitor drugs.

At the same time, the plasma aldosterone is typically greater than 600 pmol/L and the aldosterone/renin ratio > 55.

Hyperreninemia:

ACEIs, ARBs, diuretics, and aldosterone antagonists can increase renin up to levels of 300 mU/L.

Renovascular disease:

Very high renin levels (>300) suggest renovascular disease. In young patients the cause may be fibromuscular dysplasia, and in older patients it is more likely to be due to atherosclerosis.


Contact Information

The chemical pathology team can be reached via email: chemicalpathologist@adhb.govt.nz or via Lablink (09) 307 4949 ext 22000 or 09-3078995

Emails will receive priority attention from the on-call chemical pathologist. Include the patients NHI.

After-hours: contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours .



Specimen Transport Instructions for Referring Laboratories

Sample

5 mL EDTA

1 mL Paediatric EDTA

Sample Preparation
  • Centrifuge and separate plasma (minimum 0.8mL)
  • Separated plasma is stable for 5 days at room temperature
  • If time to LabPlus will be greater than 5 days - freeze aliquot

DO NOT refrigerate or chill in any way

Transport to LabPlus
  • Send aliquot at room temperature if it will reach LabPlus within 5 days
  • If time to LabPlus will be greater than 5 days - send as a frozen aliquot

DO NOT refrigerate or chill in any way



Last updated at 11:42:03 16/01/2026