The presence of a low creatinine means that the sample may not be urine. Are laboratories using a lower limit for creatinine at which they do not report a result because it is unlikely to be reliable either because it is a very dilute urine or not urine at all. At levels of less than 2 mmol/L we put a comment on “NB dilute urine negative result may not exclude drug use” I am thinking that at creatine levels <0.5 mmol/L (in adults) we should not report a result at all because it is very likely to be unreliable. I am concerned that our comments are either not seen or not understood on occasions and feel reluctant to instigate a whole series of other tests to check the sample. Do we ever see reliable samples with these very low creatinine results.
Paul
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