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Epinephrine/Creatinine Ratio, Urine

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

Measures epinephrine relative to creatinine in urine to help assess catecholamine production, usually as part of an evaluation for an adrenal or nervous-system tumor.

Quick summary

["An elevated urine epinephrine-to-creatinine ratio may indicate excess catecholamine production, but results must be interpreted with other tests and collection conditions."]

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

Key facts at a glance

LOINC
24522-5
Short code
Epineph/Creat Ur-sRto
Synonyms
Epineph/Creat Ur-sRto
Category
kidney
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 the amount of epinephrine in urine relative to the amount of creatinine. Creatinine is included because it helps account for how concentrated or dilute the urine is.

Why might I need this test?

It may be ordered when symptoms suggest excess catecholamines, such as episodes of headache, sweating, rapid heartbeat, or blood-pressure changes. It is generally interpreted together with other urine or blood tests.

How is the test performed?

A urine specimen is collected according to the laboratory's instructions, either as a single sample or over a specified period. The laboratory measures epinephrine and creatinine and reports their ratio.

How do I prepare for the test?

Follow the collection instructions exactly, including any timed collection. Tell the care team about medicines, caffeine, nicotine, exercise, illness, or stress around collection because these can affect the result.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An elevated ratio may be associated with increased catecholamine production, including conditions such as pheochromocytoma or paraganglioma. Exercise, emotional stress, caffeine, nicotine, illness, and certain medicines can also temporarily increase results, so an abnormal value usually requires repeat testing and clinical review.

Short name

Urine epinephrine-to-creatinine ratio

Frequently asked questions

Does this test diagnose a tumor by itself?
No. This test can help identify increased catecholamine production, but diagnosis requires symptoms, other laboratory studies, and often imaging.
Why is creatinine included?
Creatinine helps show how concentrated the urine is. Including it makes the epinephrine result easier to interpret across different urine samples.
Can medicines or everyday activities affect the result?
Yes. Exercise, stress, caffeine, nicotine, illness, and some medicines may affect urine epinephrine levels. Follow the laboratory's preparation and collection instructions.
  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