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Urine Malate-to-Creatinine Ratio

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

Measures the amount of malate relative to creatinine in urine, helping account for differences in urine concentration.

Quick summary

["This urine test measures malate excretion relative to creatinine, which helps interpret how much malate is being lost in the urine."]

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

Key facts at a glance

LOINC
13770-3
Short code
Malate/Creat Ur
Synonyms
Malate/Creat 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?

This test measures the amount of malate, a small molecule involved in cellular energy metabolism, relative to creatinine in your urine. The ratio helps account for variations in urine concentration, so it may provide a more useful measure of malate excretion than either measurement alone.

Why might I need this test?

A clinician may order this test as part of an evaluation of unusual urinary findings, suspected metabolic conditions, or impaired processing of certain organic acids. It may also be used in the care of people with kidney, intestinal, or inherited metabolic disorders.

How is the test performed?

A urine sample is collected and tested to determine its malate and creatinine concentrations. The laboratory then calculates the malate-to-creatinine ratio. Depending on the clinical situation, the urine may be a single specimen or a timed collection.

How do I prepare for the test?

Follow the collection instructions provided by your clinician or laboratory, including whether a first-morning, random, or timed specimen is required. Tell the healthcare team about your diet, supplements, medications, and any recent illness, as these can affect the results.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine Malate/Creatinine Ratio

Frequently asked questions

Why is creatinine included in this test?
Urine concentration can vary from sample to sample. Comparing malate with creatinine helps normalize the malate measurement so it is less affected by how concentrated or dilute the urine is.
Do I need to fast before this test?
Fasting is not always required, but your clinician may give specific dietary instructions. Because diet and supplements can affect malate excretion, follow any preparation instructions provided with the urine collection.
What does an abnormal result mean?
An abnormal ratio may reflect changes in metabolism, kidney handling, intestinal absorption, hydration, or recent intake. It does not identify a specific condition by itself and must be interpreted alongside the rest of your evaluation.
  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