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Creatinine is a metabolic by-product of muscle metabolism, and normally appears in urine in relatively constant quantities over a 24 hour period with normal liquid intake. Therefore, urine creatinine can be used as an indicator of urine water content or as a marker identifying a specimen as urine. Greater than normal intake of water will increase the urine water content (lowering the creatinine level) consequently diluting the amount of drug in urine. Conversely, a limited intake of water can lead to an abnormally concentrated urine specimen (as occurs with dehydration) resulting in elevated creatinine levels.
The creatinine levels in both urine and blood are determined and compared. Normal creatinine clearance for healthy women is 88-128 mL/min. and 97 to 137 mL/min. in males (normal levels may vary slightly between labs). Blood urea nitrogen (BUN) level is another indicator of kidney function.