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Urine Orotate-to-Creatinine Ratio

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

Measures urine orotate relative to creatinine, helping evaluate possible disorders of pyrimidine metabolism while accounting for urine concentration.

Quick summary

["An elevated urine orotate-to-creatinine ratio may suggest an inherited problem with pyrimidine metabolism, particularly hereditary orotic aciduria."]

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

Key facts at a glance

LOINC
17869-9
Short code
Orotate/Creat Ur-sRto
Synonyms
Orotate/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 orotate in urine compared with the amount of creatinine. Creatinine is used as a reference to help account for differences in urine concentration.

Why might I need this test?

It may be used to help evaluate symptoms or growth problems that could be related to an inherited disorder of pyrimidine metabolism. It is also used in the evaluation of suspected hereditary orotic aciduria.

How is the test performed?

A urine specimen is collected and analyzed in the laboratory. The laboratory measures orotate and creatinine and calculates their ratio to reduce the effect of variations in urine concentration.

How do I prepare for the test?

Follow the laboratory's collection instructions, which may call for a first-morning, random, or timed urine sample. If a 24-hour collection is requested, record the start and finish times and collect all urine during that period; fasting is generally not required.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine Orotate-to-Creatinine Ratio

Frequently asked questions

What does the urine orotate-to-creatinine ratio measure?
It measures the relative amount of orotate and creatinine in urine. The ratio helps normalize orotate for variations in how concentrated the urine is.
What conditions can cause an elevated result?
Hereditary orotic aciduria is an important cause of an elevated result. Age, diet, and other clinical factors may also affect the ratio, so results require professional interpretation.
Does this test require a 24-hour urine collection?
Not always. The laboratory may request a first-morning or random urine sample, depending on the test protocol; follow the specific collection instructions provided.
  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