Department of Chemistry, School of Engineering Science in Chemistry, Biochemistry and Health, Royal Institute of Technology, KTH, Teknikringen 30, SE-100 44 Stockholm, Sweden.
Department of Chemistry, School of Engineering Science in Chemistry, Biochemistry and Health, Royal Institute of Technology, KTH, Teknikringen 30, SE-100 44 Stockholm, Sweden.
Biosens Bioelectron. 2019 Apr 1;130:110-124. doi: 10.1016/j.bios.2019.01.048. Epub 2019 Jan 30.
The importance of knowing creatinine levels in the human body is related to the possible association with renal, muscular and thyroid dysfunction. Thus, the accurate detection of creatinine may indirectly provide information surrounding those functional processes, therefore contributing to the management of the health status of the individual and early diagnosis of acute diseases. The questions at this point are: to what extent is creatinine information clinically relevant?; and do modern creatinine (bio)sensing strategies fulfil the real needs of healthcare applications? The present review addresses these questions by means of a deep analysis of the creatinine sensors reported in the literature over the last five years. There is a wide range of techniques for detecting creatinine, most of them based on optical readouts (20 of the 33 papers collected in this review). However, the use of electrochemical techniques (13 of the 33 papers) is recently emerging in alignment with the search for a definitive and trustworthy creatinine detection at the point-of-care level. In this sense, biosensors (7 of the 33 papers) are being established as the most promising alternative over the years. While creatinine levels in the blood seem to provide better information about patient status, none of the reported sensors display adequate selectivity in such a complex matrix. In contrast, the analysis of other types of biological samples (e.g., saliva and urine) seems to be more viable in terms of simplicity, cross-selectivity and (bio)fouling, besides the fact that its extraction does not disturb individual's well-being. Consequently, simple tests may likely be used for the initial check of the individual in routine analysis, and then, more accurate blood detection of creatinine could be necessary to provide a more genuine diagnosis and/or support the corresponding decision-making by the physician. Herein, we provide a critical discussion of the advantages of current methods of (bio)sensing of creatinine, as well as an overview of the drawbacks that impede their definitive point-of-care establishment.
了解人体肌酐水平的重要性与肾脏、肌肉和甲状腺功能障碍有关。因此，准确检测肌酐可能会间接提供与这些功能过程相关的信息，从而有助于管理个体的健康状况并早期诊断急性疾病。目前的问题是：肌酐信息在多大程度上具有临床相关性？；现代肌酐（生物）传感策略是否满足医疗保健应用的实际需求？本综述通过对过去五年文献中报道的肌酐传感器进行深入分析来回答这些问题。目前有多种检测肌酐的技术，其中大多数基于光学读数（在本文综述中收集的 33 篇论文中有 20 篇）。然而，电化学技术（本文综述中收集的 33 篇论文中有 13 篇）的使用最近随着在即时检测水平上对明确和可靠的肌酐检测的需求而出现。在这方面，生物传感器（本文综述中收集的 33 篇论文中有 7 篇）多年来已成为最有前途的替代方案。虽然血液中的肌酐水平似乎提供了更好的患者状况信息，但在如此复杂的基质中，没有一种报道的传感器具有足够的选择性。相比之下，分析其他类型的生物样本（例如唾液和尿液）在简单性、交叉选择性和（生物）污染方面似乎更可行，此外，其提取不会干扰个体的健康。因此，简单的测试可能很可能用于常规分析中对个体的初步检查，然后，更准确的血液肌酐检测可能需要提供更真实的诊断和/或支持医生做出相应的决策。在这里，我们对当前肌酐（生物）传感方法的优势进行了批判性讨论，并概述了阻碍其即时检测建立的缺点。
