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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.
Normal random urine creatinine concentrations range from 40-300. mg/dL in males and 37-250 mg/dL in females. Values as low as 17. mg/dL have been observed in rare instances. Certain physiological. conditions such as diabetes may result in consistently dilute urine.