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Vanillylmandelic Acid/Creatinine Ratio, Urine

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

A urine test that measures the amount of the catecholamine breakdown product VMA relative to creatinine, which helps account for differences in urine concentration.

Quick summary

["This ratio can help screen for tumors that produce catecholamines, particularly neuroblastoma in children."]

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

Key facts at a glance

LOINC
14948-4
Short code
VMA/Creat Ur-sRto
Synonyms
VMA/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 vanillylmandelic acid (VMA), a breakdown product of catecholamines, in urine. The VMA result is compared with the amount of creatinine in the same urine sample, making it less dependent on how concentrated or dilute the urine is.

Why might I need this test?

This test is most often used to help evaluate suspected neuroblastoma or another catecholamine-producing tumor. It may also be used to monitor certain tumors or assess symptoms that could be related to excess catecholamines.

How is the test performed?

A urine specimen is collected according to the laboratory's instructions and analyzed for VMA and creatinine. Depending on the test order, the laboratory may use a single urine sample or require a timed collection, such as a 24-hour collection.

How do I prepare for the test?

Follow the laboratory's collection instructions carefully, including how much urine to collect and how long to collect it. Tell the laboratory about medicines, supplements, and recent vigorous exercise, because these and certain foods or drinks can affect the result.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Urine VMA/Creatinine Ratio

Frequently asked questions

What is VMA?
Vanillylmandelic acid is a breakdown product formed when the body breaks down catecholamines such as adrenaline, noradrenaline, and dopamine.
Why is the result divided by creatinine?
Creatinine is used as a reference for urine concentration. Including it helps clinicians interpret VMA levels even when urine is more or less concentrated than expected.
Does an abnormal result confirm that a tumor is present?
No. An abnormal result can suggest a catecholamine-producing tumor, but medications, diet, illness, and other factors can also affect the result. Your clinician will interpret it alongside symptoms, examination findings, and any additional tests.
  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