Test Catalog

Test ID: CRT24    
Creatinine, 24 Hour, Urine

Useful For Suggests clinical disorders or settings where the test may be helpful

Urinary creatinine, in conjunction with serum creatinine, is used to calculate the creatinine clearance, a measure of renal function


Normalizing urinary analytes to account for the variation in urinary concentration

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Creatinine is formed from the metabolism of creatine and phosphocreatine, both of which are principally found in muscle. Thus, the amount of creatinine produced is in large part dependent upon the individual's muscle mass and tends not to fluctuate much from day-to-day.


Creatinine is not protein-bound and is freely filtered by glomeruli. All of the filtered creatinine is excreted in the urine.


Renal tubular secretion of creatinine also contributes to a small proportion of excreted creatinine. Although most excreted creatinine is derived from an individual's muscle, dietary protein intake, particularly of cooked meat, can contribute to urinary creatinine levels.


The renal clearance of creatinine provides an estimate of glomerular filtration rate.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Only orderable as part of a profile. For more information see:

-NMH24 / N-Methylhistamine, 24 Hour, Urine

-RBP24 / Retinol-Binding Protein, 24 Hour, Urine


Normal values mg per 24 hours:

Males: 930-2955 mg/24 hours

Females: 603-1783 mg/24 hours


Reference values have not been established for patients who are less than 18 years of age.


For SI unit Reference Values, see International System of Units (SI) Conversion

Interpretation Provides information to assist in interpretation of the test results

Decreased creatinine clearance indicates decreased glomerular filtration rate. This can be due to conditions such as progressive renal disease, or result from adverse effect on renal hemodynamics that are often reversible including certain drugs or from decreases in effective renal perfusion (eg, volume depletion or heart failure).


Increased creatinine clearance is often referred to as "hyperfiltration" and is most commonly seen during pregnancy or in patients with diabetes mellitus, before diabetic nephropathy has occurred. It also may occur with large dietary protein intake.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

The reliability of 24-hour urinary creatinine determinations is, as for all timed urine collections, very dependent on accurately collected 24-hour specimens.


Intraindividual variability in creatinine excretion may be due to differences in muscle mass or amount of ingested meat.


Acute changes in glomerular filtration rate, before a steady state has developed, will alter the amount of urinary creatinine excreted.


Rifampicin, levodopa, and calcium dobesilate (eg, Dexium) cause artificially low creatinine results. As tested, according to CLSI recommendation, methyldopa causes artificially low creatinine results.


Dicynone (Etamsylate) at therapeutic concentrations may lead to falsely low results.


N-ethylglycine at therapeutic concentrations and DL-proline at concentrations greater or equal to 1 mmol/L gives falsely high results.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Delaney MP, Lamb EJ: Kidney disease. In: Rifai N, Horvath AR, Wittwer CT, eds: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:1256-1323

2. Meeusen J, Rule A, Voskoboev, N, Baumann N, Lieske J: Performance of cystatin C- and creatinine-based estimated glomerular filtration rate equations depends on patient characteristics. Clin Chem. 2015 Oct;61(10):1265-1272. doi:10.1373/clinchem.2015.243030

3. Newman DJ, Price CP: Renal function and nitrogen metabolites. In: Burtis CA, Ashwood ER, eds. Tietz Textbook of Clinical Chemistry. 3rd ed. WB Saunders Company; 1999:1204-1270

4. Kasiske BL, Keane WF: Laboratory assessment of renal disease: clearance, urinalysis, and renal biopsy. In: Brenner BM, ed. The Kidney. 6th ed. WB Saunders Company; 2000:1129-1170

Special Instructions Library of PDFs including pertinent information and forms related to the test