Sorted By Test Name - Mayo Medical Laboratories

88501
PRA
8060
Clinical References: 1. Tisher CC: Clinical indication for kidney biopsy. In Renal Pathology: with
Clinical and Functional Correlations. Vol. II. 2nd edition. Edited by CC Tisher, BM Brenner.
Philadelphia, JB Lippincott Company, 1993, pp 75-84 2. Pirani CL: Evaluation of kidney biopsy
specimens. In Renal Pathology: with Clinical and Functional Correlations. Vol. II. 2nd edition. Edited by
CC Tisher, BM Brenner. Philadelphia, JB Lippincott Company, 1993, pp 85-115 3. Pirani CL, Croker BP:
Handling and processing of renal biopsy and nephrectomy specimens. In Renal Pathology: with Clinical
and Functional Correlations. Vol. II. 2nd edition. Edited by CC Tisher, BM Brenner. Philadelphia, JB
Lippincott Company, 1993, pp 1683-1694
Renal Pathology Consultation
Clinical Information: The Mayo Renal Pathology service is staffed by board certified pathologists
who have a special interest in non-neoplastic diseases of the kidney. Kidney biopsy has proven to be of
value in the clinical evaluation and management of patients with kidney disease, including acute and/or
chronic renal insufficiency, nephrotic syndrome, nephritic syndrome, proteinuria and/or hematuria, and in
the overall management of renal transplant recipients. Optimal interpretation of a kidney biopsy requires
integration of clinical and laboratory results with light microscopic, immunofluorescent histology, and
electron microscopy findings.
Useful For: The evaluation and management of patients with kidney disease Following the progression
of known renal disease and/or response to therapy Determining the cause of dysfunction in the
transplanted kidney (allograft)
Interpretation: A verbal report of the findings is typically communicated by phone to the submitting
Nephrologist, and an initial report based on the light microscopic and immunofluorescent histology
interpretation is also faxed to the Nephrologist. A report is also sent to the submitting Pathology
Laboratory. Representative electron microscopy images and significant positive immunofluorescent stain
findings can be provided on a CD upon request. In most cases, the electron microscopy results are
reported as an addendum and a final report is issued include these findings. This final report is again faxed
to the submitting Nephrologist and mailed to the submitting Pathology Laboratory, along with a
representative set of the light microscopy slides.
Reference Values:
An interpretive report will be provided.
Renin Activity, Plasma
Clinical Information: The renal juxtaglomerular apparatus generates renin, an enzyme that converts
angiotensinogen to angiotensin I. The inactive angiotensin I is enzymatically converted to the active
octapeptide angiotensin II, a potent vasopressor responsible for hypertension of renal origin. Angiotensin
II also stimulates the zona glomerulosa of the adrenal cortex to release aldosterone. Renin secretion by the
kidney is stimulated by a fall in glomerular blood pressure, by decreased sodium concentration at the
macula densa at the distal tubule, or by stimulation of sympathetic outflow to the kidney, such as in renal
vascular diseases.
Useful For: Investigation of primary aldosteronism (eg, adrenal adenoma/carcinoma and adrenal
cortical hyperplasia) and secondary aldosteronism (renovascular disease, salt depletion, potassium
loading, cardiac failure with ascites, pregnancy, Bartter's syndrome)
Interpretation: A high ratio of serum aldosterone (SA) in ng/dL to plasma renin activity (PRA) in
ng/mL per hour, is a positive screening test result, a finding that warrants further testing. A SA/PRA ratio
> or =20 and SA > or =15 ng/dL indicates probable primary aldosteronism. Renal disease, such as
unilateral renal artery stenosis, results in elevated renin and aldosterone levels. Renal venous
catheterization may be helpful. A positive test is a renal venous renin ratio (affected/normal) >1.5. See
"Renin - Aldosterone Studies" in Special Instructions
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