The urinary creatinine concentration (CC) represents the actual creatinine concentration in the specimen that was submitted.

Under normal conditions, the rate of excretion of creatinine is quite constant and highly correlated with lean body mass (muscle). However, the CC can vary significantly as a function of urine volume. An unusually high CC most likely indicates poor hydration of the patient at the time of the urine collection. A very low CC most likely indicates unusually high fluid consumption, or perhaps the influence of diuretics. If the urine specimen is very dilute (extremely low CC), the accuracy of the amino acid analysis may be compromised due to analytical detection limits. It is emphasized that the CC in this specimen should not be utilized to assess renal function or glomerular filtration. For that purpose, one should perform a bona fide creatinine clearance test.

For a given age and gender, intra-individual variability in daily creatinine excretion can vary by as much as two-fold. Therefore, to more accurately assess amino acid status using a random collection, the reported values for each analyte are expressed per gram ”normalized” creatinine. Creatinine values are adjusted to account for body surface area (BSA) using the formula:

CreatinineN (Normalized) = creatinine concentration x (1.73/BSA).