Theoretical Analysis of d-Serine and d-Asparagine as Biomarkers for Glomerular Filtration Rate

Chronic kidney disease (CKD) is a major global health issue, requiring accurate and noninvasive renal function assessment. Glomerular filtration rate (GFR) is the standard measure, but current methods, including inulin clearance and creatinine-based estimation, have limitations in accuracy, invasiveness, and practicality. We investigated d-serine and d-asparagine as novel endogenous biomarkers for GFR evaluation. Their clearance strongly correlates with inulin clearance, demonstrating high reliability and reduced muscle mass dependency compared to creatinine-based methods. Our findings suggest that d-amino acids offer a promising, less invasive alternative for precise renal function assessment, aiding early CKD detection and management. In addition, d-amino acids have recently been reported to be useful as biomarkers not only in the renal field but also in various other fields such as malignancy and infectious diseases. This article highlights the potential of d-amino acids in enhancing CKD diagnosis and management.