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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.
1 A creatinine urine test evaluates how well your kidneys are working by measuring the amount of creatinine in your urine.  A urine 24-hour volume test is the most common type creatinine urine test. Since the urine 24-hour volume test simply involves urination, there are no associated health risks or side effects.