Aldosterone to direct renin ratio calculator
A calculated ratio of aldosterone to direct renin concentration. Clinicians use it as a first step when looking into primary aldosteronism in people with high blood pressure. Type your results in the units on your report and it works out ADRR as you type, in your browser.
AI-verified against cited sources. Awaiting expert reviewLast reviewed 2026-10-03Stress & Growth Hormones
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Educational information, not medical advice. Blood Test Tracker doesn’t diagnose or treat, and it doesn’t replace your clinician. Talk with your clinician before changing medications, supplements or care.
How it’s worked out
The formula
ADRR = aldosterone (ng/dL) ÷ direct renin concentration (pg/mL, which equals ng/L). Ratios that use renin in mIU/L are on a different scale and can't be converted without the assay's own factor.
Fasting before the blood test: recommended. Morning, seated, without a long tourniquet time (ARUP and the Endocrine Society 2025). If lying down, ARUP asks for at least 30 minutes in that position first. Fasting is recommended but not required (Cleveland Clinic Laboratories).
A worked example
Example numbers, not anyone’s real results, run through the same code as the calculator above.
| Aldosterone | 10 ng/dL |
|---|---|
| Direct renin | 15 pg/mL |
| ADRR | 0.7 ng/dL per pg/mL |
For an adult, this result is in the usual range.
What ADRR tells you
Aldosterone and renin normally move in step: when renin falls, aldosterone should fall too. This version of the ratio uses direct renin concentration, which is the amount of active renin in the blood, rather than renin activity. The two renin tests are not interchangeable, so a ratio made with one can't be compared with cut points made for the other. Labs get the ratio by dividing aldosterone by direct renin, so it depends on both measurements and on the units used.
The ratio is a first-step test, not a diagnosis. A result above the cut point is a reason for more testing. The Endocrine Society's 2025 guideline suggests testing aldosterone and renin in everyone with high blood pressure, because primary aldosteronism is often missed. The ratio can mislead. Medicines, potassium, salt intake and age can push it up or down. With direct renin, the menstrual cycle and estrogen also matter. Both false alarms and missed cases happen, so your own lab's cut point matters.
Read the full page on ADRR, with what a high or low result can mean.
Usual ranges
The ranges the result above is placed on. Your own lab’s printed range comes first if it gives one.
- Adultsup to 4 ng/dL per pg/mL
Sources: ARUP Laboratories, ARUP Consult, Cleveland Clinic Laboratories
Sources
The equation
- Aldosterone and Renin Direct, With Ratio (test 3005949), ARUP Laboratories
- Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline, Journal of Clinical Endocrinology & Metabolism (2025)
3 more sources for the ranges and the explanation
- Aldosterone/Direct Renin Ratio (test ALDREN), Cleveland Clinic Laboratories
- Aldosterone-Renin Ratio (Test Fact Sheet), ARUP Consult (2026)
- Aldosterone (PubChem CID 5839), NCBI PubChem
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-03. The calculator is version 1.0.0 of our code for this equation, tested against published examples. How we build and check these pages.