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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.
As blood flows through the kidneys, creatinine is excreted out into your urine along with other waste products. Levels of creatinine in the urine taken over 24 hours, together with blood levels of creatinine, can be used to estimate the rate at which your kidneys do their filtering job.