eBook | November 20, 2025
Marker of the Month | Creatinine
Sapient's Marker of the Month series explores known & novel associations of key established biomarkers using Sapient’s DynamiQ™ Insights Engine – seeking to uncover new insights to capture the broader biological disruptions underlying disease and opportunities to improve diagnostic precision.
This month we take a closer look at creatinine, the most widely used surrogate biomarker of kidney function.
Biological origin and disease associations
Creatinine is a normal waste product that the human body produces when muscle tissue breaks down. While it has no active biological function, it can be used to assess the efficiency with which the kidneys filter waste from the body.
A serum or urine creatinine assay reflects glomerular filtration rate (GFR): if filtration declines, creatinine rises, which can indicate impaired kidney health stemming from kidney diseases or other metabolic disorders including type 2 diabetes (T2D) and cardiovascular disease. Low creatinine levels are also associated with reduced muscle mass and certain liver diseases.
Clinical signficance of creatinine assays
Creatinine is a well-established and widely used biomarker to calculate estimated GFR (eGFR) in serum or for direct filtration estimation of creatinine clearance from 24-hour urine. However, creatinine assays do have shortcomings to be considered in clinical interpretation. For example, creatinine provides limited sensitivity to detect early kidney dysfunction, as renal function can be decreased by as much as 50% before a rise in serum creatinine is observed.
While creatinine remains an indispensable biomarker for clinical practice, integration with additional or alternative biomarkers may offer a more precise and timely view of renal health.
To that end, Sapient has used our DynamiQ™ Insights Engine to profile creatinine in patients with CKD and T2D and to probe these questions:
- Can we replicate known associations between creatinine and these diseases in our DynamiQ cohorts?
- Can we identify other biomarkers beyond creatinine that show similarly strong correlation with CKD and T2D?
- What more can we learn about creatinine within the broader context of metabolic disruptions involved in these diseases?
Exploration of creatinine in DynamiQ
Through the analysis of 8,320 samples collected from 2,462 individuals in Sapient’s DynamiQ database, we are able to generate many exciting insights related to creatinine and its role in broader metabolic dysregulations associated with key diseases like T2D and chronic kidney disease (CKD).
Across more than 15,000 metabolites, we identified hundreds of molecules that are differentially expressed in both incident and prevalent T2D and CKD. Creatinine ranks among the most significantly altered metabolites, consistent with well-established clinical reporting, but we also find multiple other metabolites that exhibit even larger effect sizes which may represent novel biomarkers with greater association strength than creatinine.
View the full Marker of Month eBook to see the data behind these key metabolites, including their distinct distribution patterns between cases (individuals with T2D or CKD) and controls. We also explore inter-metabolite associations with creatinine in both CKD patients and healthy individuals which suggest creatinine is part of a broader metabolic network disruption contributing to disease state.
Extending creatinine insights with novel markers of the future
Creatinine remains one of the most widely used and clinically validated biomarkers for assessing kidney function, owing to its clear physiological origin and established role in estimating GFR. However, its limitations – such as lack of sensitivity to detect early kidney dysfunction – highlight the need for broader metabolic context.
Our DynamiQ™ analysis confirms creatinine’s strong association with CKD and T2D, consistent with clinical expectations, while also revealing metabolites with even greater effect sizes and distinct correlation patterns. These findings underscore the importance of discovery metabolomics to probe the broader landscape of human chemistry, revealing novel biomarkers and biomarker signatures that expand our disease understanding.
Such analyses can enable the integration of creatinine with additional biomarkers to capture the broader metabolic disruptions underlying disease and improve diagnostic precision. By expanding beyond traditional markers, we can advance toward more comprehensive and personalized approaches to address kidney and metabolic diseases.
Interested in exploring your marker of interest in Sapient’s DynamiQ database? Ready to expand the scope of your biomarker analyses to reveal novel insights?
Reach out to schedule a time to speak with our scientists.