Viteri and Alvarado developed the creatinine height index to compare a child's measured urine creatinine excretion relative to that expected based on body height.

Patient selection: child


creatinine height index =

= (actual 24 hour urine creatinine excretion for the child) / (24 hour creatinine excretion of a normal child with same height)


actual urine creatinine excretion in mg per 24 hours =

= (24 hour urine volume in mL) / 100 * (urine creatinine in mg per dL)


expected urine creatinine excretion in mg per 24 hours =

= 252 - (8.01 * (height in cm)) + (0.0817 * ((height in cm)^2))



• According to Tietz (Clinical Guide to Laboratory Tests, Third Edition, page 188), the reference range for a child's urine creatinine excretion should be 8-22 mg per kg per day.

• The 24 hour urine creatinine for normal children from 0 months to 8 years of age are given n Table I, page 697 in Viteria and Alvarado (1970)


ratio of actual to expected urine creatinine excretion =

= (actual urine creatinine excretion) / (predicted urine creatinine excretion)



• A normal child should have a ratio close to 1.

• A malnourished child with protein deficiency would have a significantly reduced ratio. With protein repletion the ratio should increase towards 1.



• As with any 24 hour urine study, a complete 24 hour urine collection is required for an accurate result.

• Using the urine creatinine as a measure of protein malnutrition assumes normal renal function.

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