Role of Serum Creatinine, Serum Urea, and Urinary Albuminuria as Primary Biomarkers for Diagnosing and Monitoring Chronic Kidney Disease

Abstract

Background: Chronic kidney disease (CKD) is a progressive condition with high global morbidity, yet early diagnosis remains challenging due to a lack of sensitive, accessible biomarkers. There is a need to clarify the comparative diagnostic and monitoring value of routinely available serum creatinine, serum urea, and urinary albuminuria across CKD stages. Objective: This study aimed to evaluate and compare the roles of serum creatinine, serum urea, and urinary albuminuria as primary biomarkers for diagnosing and monitoring CKD progression in adults, hypothesizing that albuminuria offers superior early-stage sensitivity. Methods: This cross-sectional observational study included 100 CKD patients at Ahmed Medical Complex Hospital, Lahore. Adults diagnosed with CKD of any stage were enrolled based on clinical and laboratory evidence; patients with acute kidney injury, dialysis, pregnancy, liver disease, or malignancy were excluded. Blood and urine samples were analyzed for creatinine, urea, and albuminuria using standardized laboratory assays. Data were collected following written informed consent and ethical approval in accordance with the Helsinki Declaration. Analysis was performed in SPSS v26.0 using non-parametric tests (Kruskal-Wallis, Mann-Whitney U, and Spearman correlation), with p < 0.05 considered significant. Results: Mean serum creatinine, urea, and albuminuria were 2.2 mg/dL, 63.8 mg/dL, and 47.5 mg/g, respectively. All biomarkers increased significantly with CKD stage (p = 0.001); albuminuria demonstrated the strongest correlation with disease progression (r = 0.888, p < 0.001). No significant gender differences were observed (p > 0.05). Conclusion: Serum creatinine, serum urea, and especially urinary albuminuria are reliable biomarkers for CKD diagnosis and monitoring, with albuminuria providing the earliest clinical signal of renal injury. Routine integration of these tests can improve early detection and outcomes in CKD management.