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Urine Pipecolate-to-Creatinine Ratio

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

A urine test that measures pipecolate relative to creatinine. It may help evaluate suspected disorders of peroxisome function, particularly in infants and children.

Quick summary

["An elevated urine pipecolate-to-creatinine ratio can suggest a disorder affecting peroxisomes, but results require specialist interpretation."]

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

Key facts at a glance

LOINC
47727-3
Short code
Pipecolate/Creat Ur-sRto
Synonyms
Pipecolate/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 pipecolate, also called pipecolic acid, in urine relative to the amount of creatinine. Creatinine is used to help account for differences in urine concentration.

Why might I need this test?

The test may be ordered when a clinician is evaluating a child with developmental delay, seizures, unusual muscle tone, impaired vision or hearing, or other findings that could be associated with a peroxisome-related disorder.

How is the test performed?

A urine sample is collected and analyzed in a laboratory. The laboratory measures pipecolate and creatinine and calculates their ratio to help account for how concentrated or dilute the urine is.

How do I prepare for the test?

Follow the urine collection instructions provided by your clinician or laboratory, including whether a first-morning or timed collection is required. Tell the healthcare team if the child is taking medications or has recently had an illness, as these factors may affect interpretation.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine pipecolate-to-creatinine ratio

Frequently asked questions

Is this the same as a urine pipecolic acid test?
It is related because pipecolate is another name for pipecolic acid. This test reports pipecolate relative to urine creatinine rather than as a standalone measurement.
Why is creatinine included in the result?
Creatinine helps show how concentrated the urine is. Including it makes it easier to compare pipecolate measurements from samples with different amounts of water.
Does an elevated result mean a specific diagnosis?
No. An elevated result can raise concern for a peroxisome-related disorder, but it does not identify one condition on its own. Your clinician will interpret it alongside the medical history and other 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