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Homovanillic Acid/Creatinine Ratio, Urine

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

A urine test that measures the catecholamine metabolite homovanillic acid relative to creatinine, often used to evaluate and monitor suspected neuroblastoma.

Quick summary

["An elevated urine HVA-to-creatinine ratio can be associated with neuroblastoma but requires clinical interpretation."]

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

Key facts at a glance

LOINC
51994-2
Short code
HVA/Creat ?Tm Ur
Synonyms
HVA/Creat ?Tm Ur
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?

Homovanillic acid, or HVA, is a breakdown product of catecholamines. This urine test measures HVA relative to creatinine, a substance used to help account for how concentrated the urine is.

Why might I need this test?

Urine HVA is most often used to help evaluate suspected neuroblastoma, especially in children, and to monitor treatment or possible recurrence. It may also be used in the assessment of other rare catecholamine-producing conditions.

How is the test performed?

A urine sample is analyzed in the laboratory for HVA and creatinine, and the results are reported as a ratio. Depending on the order, this may be measured in a single urine sample or in urine collected over 24 hours.

How do I prepare for the test?

Follow the laboratory's collection instructions and tell your clinician about medicines, supplements, and unusual changes in diet. If a 24-hour collection is required, collect all urine for the specified period, keep it refrigerated if directed, and record the total volume.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine HVA-to-creatinine ratio

Frequently asked questions

Is urine HVA the same as a urine catecholamine test?
No. HVA is a specific breakdown product measured in urine, while a urine catecholamine test may measure several catecholamines and their metabolites.
Why is creatinine included in the result?
Creatinine helps show how concentrated the urine is. Including it in the ratio makes the HVA result less dependent on variations in urine volume.
Does an elevated HVA result mean someone has cancer?
Not necessarily. An elevated ratio can suggest a catecholamine-producing condition, but it can have other causes and must be interpreted by a clinician using the full clinical picture.
  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