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Urinary Cortisol-to-Creatinine Ratio (Calculated)

Published: August 9, 2026Updated: August 16, 2026

A urine test that compares cortisol with creatinine, helping account for differences in urine concentration.

Quick summary

["This ratio measures urinary cortisol relative to creatinine and is sometimes used to screen for excess cortisol production."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
108589-3
Short code
A-Cortol/Creat Msmt Ur
Synonyms
A-Cortol/Creat Msmt Ur
Category
liver
Sample
urine
Container
Sterile urine container
Units
N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
Specimen volume
10 mL
Stability
Room temperature: 2h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
0
Lipemia max
0
Icterus max
0
TAT
4–24 hours
Order
routine

What is this test?

This test measures cortisol in urine and compares it with the amount of creatinine in the same sample. The calculated ratio helps reduce the effect of variations in urine concentration.

Why might I need this test?

A clinician may order it when there are signs of excess cortisol, such as unusual weight gain, bruising, muscle weakness, or high blood pressure. It may also be used in evaluating children with suspected adrenal hormone disorders.

How is the test performed?

A urine sample is tested for cortisol and creatinine, and the results are used to calculate the cortisol-to-creatinine ratio. The laboratory may use a turbidimetric method to measure the urine creatinine concentration.

How do I prepare for the test?

Follow your clinician's instructions about when and how to collect the urine sample. Tell the clinician about corticosteroid, hormone, or other medicines you are taking, and do not stop any medicine unless instructed to do so.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine cortisol/creatinine ratio

Frequently asked questions

Is this the same as a 24-hour urine cortisol test?
Not necessarily. A cortisol-to-creatinine ratio can be calculated from a urine sample, while a 24-hour test measures cortisol collected over an entire day. Follow the collection instructions provided by the laboratory.
Why is creatinine included in the result?
Creatinine is used to account for how concentrated or dilute the urine sample is. This makes the cortisol result more comparable across samples.
Can medicines affect the urine cortisol ratio?
Yes. Corticosteroids and some other medicines can increase or decrease measured cortisol. Do not change prescribed medicines without medical guidance.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy