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Vanillylmandelate-to-Creatinine Ratio, 24-Hour Urine

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

Measures the amount of vanillylmandelate relative to creatinine in urine collected for 24 hours to help evaluate catecholamine metabolism.

Quick summary

["This test can help identify increased catecholamine metabolism, but results must be interpreted alongside symptoms, medications, and other tests."]

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

Key facts at a glance

LOINC
26004-2
Short code
VMA/Creat 24h Ur-sRto
Synonyms
VMA/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?

Vanillylmandelate (VMA) is a breakdown product of catecholamines, which are chemicals involved in the body's stress and nervous-system responses. This test measures VMA relative to creatinine in a 24-hour urine collection.

Why might I need this test?

It may be used to evaluate conditions involving increased catecholamine production, including neuroblastoma in children and pheochromocytoma in adults. It is often ordered based on symptoms or other screening results.

How is the test performed?

You collect all urine produced during a full 24-hour period using the container and instructions provided by the laboratory. The lab measures VMA and creatinine and calculates the VMA-to-creatinine ratio.

How do I prepare for the test?

Follow the laboratory's collection instructions carefully, including the start and end times and whether to discard the first morning urine. Tell the care team about medicines, supplements, and recent illness, and follow any food restrictions your clinician provides.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

An elevated VMA-to-creatinine ratio may indicate increased catecholamine breakdown and can occur with tumors that produce catecholamines, such as neuroblastoma or pheochromocytoma. Medications, foods, stress, and other conditions can also affect results, so an abnormal result usually requires clinical interpretation and sometimes repeat or confirmatory testing.

Short name

24-Hour Urine VMA-to-Creatinine Ratio

Frequently asked questions

Why is creatinine included in this test?
Creatinine helps show how concentrated the urine is. Comparing VMA with creatinine makes the result more useful than measuring VMA alone.
What happens if the 24-hour urine collection is incomplete?
The ratio may be inaccurate if any urine is missed or collected outside the specified time period. Follow the provided instructions exactly and contact the laboratory if you are unsure how to collect the sample.
Can medicines or foods affect the result?
Yes. Certain medicines and some foods can alter VMA levels, while stress, illness, and exercise may also affect the result. Your care team should tell you whether to adjust anything before collection; do not stop prescribed medicines without guidance.
  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