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Updated: Apr 18, 2026

Author Spotlight: Engineering Molecular Tools for Disease Detection and Imaging
Published on: December 8, 2023
Normalisation of urinary biomarkers to creatinine for clinical practice and research--when and why
Kai Wen Aaron Tang, Qi Chun Toh, Boon Wee Teo1
1Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Level 10 NUHS Tower Block, Singapore 119228. mdctbw@nus.edu.sg.
Abstract:
Acute kidney injury (AKI) and chronic kidney disease (CKD) are major health problems. Urinary biomarkers have both diagnostic and prognostic utility in AKI and CKD. However, how biomarker excretion rates should be reported, especially whether they should be normalised to urinary creatinine concentration (uCr), is controversial. Some studies suggest that normalisation to uCr may be inappropriate at times, as urinary creatinine excretion rate may vary greatly, depending on the situation. Notably, recent studies suggest that while normalisation of values to UCr may be valid for the evaluation of CKD and prediction of AKI sequelae and occurrences, it could be inappropriate for the diagnosis of AKI, or in the presence of certain acute kidney disease states.
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