Screening for kidney diseases: older measures versus novel biomarkers

Abstract

Biomarkers have been used to screen for kidney disease since creatinine was recognized to be correlated with renal function. The measurement of serum creatinine as a screening test for kidney disease falls short, however, because serum creatinine is not particularly sensitive for the diagnosis of kidney disease. Creatinine reflects renal filtering capacity, which has a lot of reserve and is therefore not sensitive to acute or chronic kidney injury unless the injury is substantial enough to compromise the filtering ability. The sensitivity of serum creatinine is further diminished in certain patient populations that are prone to kidney disease because of the physiology of creatinine. Therefore, researchers are seeking new biomarkers that can aid in the diagnosis of both acute and chronic kidney diseases. The limitations of creatinine in screening for kidney diseases in specific patient populations as well as new potential biomarkers that are actively being researched are discussed in this review.