Table 1.

Limitations of serum creatinine in acute kidney injury (AKI) and chronic kidney disease (CKD)

Disease	Limitations of serum creatinine
AKI and CKD	Nonspecific to disease etiology
	Delayed marker of kidney damage
	Dependent on clinical characteristics (age, sex, muscle mass, etc.)
	Insensitive to small changes in GFR
AKI	Dependent on hemodynamic steady state
	Altered in hospitalized patients (i.e., by diuretics, IV fluids)
	Assay-related interference (i.e., by bilirubin)
CKD	Unchanged despite kidney damage in tubulointerstitial and vascular disease
	May be falsely low with significant proteinuria
	Provides imprecise eGFR estimations
	Requires special considerations for eGFR equations with changing muscle mass (i.e., in children, cirrhotics)

Abbreviations: eGFR, estimated GFR; GFR, glomerular filtration rate.