If possible please initiate functionality tests before referral - Below is a guideline explaining what tests to request
Hyperaldosteronism: Aldosterone / renin ratio
Request Aldosterone / renin ratio should be requested after obtaing 2 bood tubes from the patient. A purple and yellow top tube are needed.
Minimum sample volumes: aldosterone 1.5 ml and renin 1.8 ml (avoid haemolysis).
Patients should maintain liberal dietary salt intake prior to testing.
Hypokalaemia should be corrected with supplemental potassium chloride tablets prior to testing (the absence of hypokalaemia does in no way exclude primary hyperaldosteronism).
Pheochromocytoma: 24 Hour Urinary Metanephrines Level
24-Hour Urine Collection
• The 24 hour collection container should be collected from the laboratory and labeled with appropriate patient identification.
The container must be acidified with hydrochloric acid, if you shake the bottle usually you can hear a small amount of liquid in the bottle
• Instructions for 24 hour urine collection for the patient:
─ Void (discard) first morning urine
─ Collect all urine passed for 24 hours including the first morning urine of the next day into a small clean container and after each void carefully transfer contents into the 24 hour urinecontainer
─ Return the 24 hour urine container to the clinic after completing the collection
Cushing syndrome: 24 Hour Urinary Cortisol Level
24-Hour Urine Collection
• The 24 hour collection container should be collected from the laboratory and labeled with appropriate patient identification.
The container must be empty with no additive
• Instructions for 24 hour urine collection for the patient:
─ Void (discard) first morning urine
─ Collect all urine passed for 24 hours including the first morning urine of the next day into a small clean container and after each void carefully transfer contents into the 24 hour urinecontainer
─ Return the 24 hour urine container to the clinic after completing the collection