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Normetanephrine/Creatinine Ratio, 24-Hour Urine

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

A 24-hour urine test that measures normetanephrine relative to creatinine to help evaluate whether the body may be producing excess catecholamines.

Quick summary

["This test helps look for evidence of excess catecholamine production, which can be associated with rare adrenal or nerve-system tumors."]

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

Key facts at a glance

LOINC
44924-9
Short code
Normetanephrine/Creat 24h Ur-sRto
Synonyms
Normetanephrine/Creat 24h 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?

Normetanephrine is a breakdown product of the stress hormones epinephrine and norepinephrine. This test measures normetanephrine in urine collected for 24 hours and compares it with urine creatinine, which helps account for differences in urine concentration.

Why might I need this test?

This test may be ordered when symptoms suggest an adrenal pheochromocytoma, paraganglioma, or another source of excess catecholamines. These may include episodic headache, sweating, rapid heartbeat, elevated blood pressure, shakiness, or unexplained episodes of pallor.

How is the test performed?

You collect all urine produced during a specified 24-hour period. The laboratory measures normetanephrine and creatinine and may report the normetanephrine-to-creatinine ratio. Follow the collection instructions exactly, because incomplete collections and variations in urine concentration can affect interpretation.

How do I prepare for the test?

Follow the instructions provided for the 24-hour collection, including when to begin and whether urine should be refrigerated. Avoid strenuous exercise and discuss caffeine, nicotine, alcohol, and medications that may affect results with your clinician. Do not stop prescribed medicines unless your clinician instructs you to do so.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

24-Hour Urine Normetanephrine

Frequently asked questions

Is this the same as a routine urine creatinine test?
No. Routine urine creatinine may be measured alone, while this test specifically compares urinary normetanephrine with creatinine to evaluate catecholamine production.
Why is a 24-hour urine collection required?
Collecting all urine for 24 hours provides a more representative measurement than a single sample. An incomplete or mistimed collection can make the result unreliable.
What if my result is elevated?
An elevated result does not by itself confirm a tumor. Your clinician will consider your symptoms, medications, collection quality, and other laboratory tests and may recommend repeat or confirmatory testing.
  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