Reliability of urinary creatinine as a parameter used to adjust values of urinary biological indicators.

The values of biological indicators used in biological monitoring are usually determined on spot samples of urine. In order to reduce the variations due to dilution, it is common practice to correct the values according to reference parameters, such as urinary creatinine concentration and specific gravity. The aim of the present study was to verify whether creatinine possesses the necessary characteristics for adjustment. The levels of creatinine were not influenced by diuresis, but, contrary to what was expected, the values of the metabolite showed marked intra- and interindividual variations. These data raise serious doubts as to the validity of creatinine as a parameter that can be used for adjustment purposes, and suggest that it would be advisable to ascertain for each biological indicator whether in fact adjustment is of any use. Lastly, since there was only a slight correlation between creatinine levels and specific gravity values, it is concluded that these two parameters cannot be used indifferently for adjustment.