Abstract
Serum creatinine, urea, and cystatin C are the main biomarkers used to estimate glomerular filtration rates in persons with and without chronic kidney disease (CKD). Frequent measurements of these assays are needed to identify patients with earlier stages of CKD, detect episodes of acute kidney injury (AKI), and monitor for CKD progression. However, the cumbersome, time-consuming nature of conventional laboratory-based kidney function assays limit more frequent monitoring and greater patient self-management. Noninvasive salivary assessments of creatinine, cystatin C, and urea make it feasible to conduct frequent monitoring of kidney function in point-of-care settings, as well as in nonclinical-care settings such as at home. Additionally, fingerstick sampling can offer an alternative route of blood testing that is suitable for home-based assessments. In this review, we provide an overview of emerging data on various salivary vs. fingerstick blood assessment methods for kidney function; their accuracy in comparison to 'gold-standard' laboratory-based methods; and their respective strengths and limitations in the clinical setting. A practical, cost-effective, minimally invasive, multimarker assessment platform has the potential to circumvent the limitation of conventional laboratory blood-based testing approaches, and thereby address a major unmet need in the management of CKD patients.
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