A novel indicator for lead poisoning beyond blood lead level: Facile diagnosis of lead poisoning using random urine with point-of-care testing

Lead (Pb) poisoning is estimated to account for 1 % of the global disease burden. The gold standard for diagnosing lead poisoning in human body relies on blood lead level (BLL), which is always performed in hospitals using expensive instruments. However, there are still many countries and regions with a lack of medical resources (without enough professional medical staff and analytical instruments). To achieve a facile diagnosis of lead poisoning by ordinary residents (without any expertise), this study conducted a research study on 810 participants to discover and validate a new lead poisoning indicator (creatinine-corrected urinary lead level, cULL) beyond BLL in non-invasive samples. A point-of-care testing (POCT) device to measure cULL was developed, equipped with liquid-phase microextraction and electromembrane extraction on a paper-based analytical device for on-site separation of lead and creatinine in the urine, using a smartphone for the quantification of analytes. The cULL as a novel indicator and the POCT device developed could be effective in reducing the risk of damage from lead contamination.

Discerning biomimetic nanozyme electrodes based on g-C3N4 nanosheets and molecularly imprinted polythiophene nanofibers for detecting creatinine in microliter droplets of human saliva

The growing risk of death associated with kidney dysfunction underlines the requirement for a cost-effective and precise point-of-care (POC) diagnostic tool to identify chronic kidney disease (CKD) at an early stage. This work reports the development of a non-invasive POC diagnostic based on cost-efficient, disposable electrodes and in situ-designed biomimetic nanozymes. The nanozymes are composed of graphitic carbon nitride nanosheets (gCN) and creatinine-imprinted polythiophene nanofibers (miPTh). Microscopic analyses reveal porous nanofibrous surface morphology of biomimetic miPTh/gCN nanozymes. Bulk imprinting and the inclusion of conductive gCN nanosheets drastically reduced the charge transfer resistance and improved the electron exchange kinetics at the nanozyme-electrolyte interface. The electrochemical oxidation of creatinine is studied via cyclic voltammetry (CV), and differential pulse voltammetry (DPV), which exhibit excellent creatinine recognition ability of biomimetic miPTh/gCN nanozyme sensors compared to pristine polymeric or non-imprinted nanozymes. The sensor reveals linear response toward 200-1000 nmol L-1 creatinine, high sensitivity (4.27 μA cm-2 nmol-1 L), sub-nanomolar detection limit (340 pmol L-1), and excellent selectivity over common salivary analytes. To corroborate its real-world utility, the miPTh/gCN nanozyme sensor shows an impressive 94.8% recovery of spiked creatinine concentrations in microliter droplets of human saliva samples. This disposable sensor reveals great potential in the realm of reliable and efficient non-invasive POC diagnostics for healthcare delivery.

Smartphone-based low-cost and rapid quantitative detection of urinary creatinine with the Tyndall effect

This research aims to develop a robust and quantitative method for measuring creatinine levels by harnessing the enhanced Tyndall effect (TE) phenomenon. The envisioned sensing assay is designed for practical deployment in resource-limited settings or homes, where access to advanced laboratory facilities is limited. Its primary objective is to enable regular and convenient monitoring of renal healthcare, particularly in cases involving elevated creatinine levels. The creatinine sensing strategy is achieved based on the aggregation of gold nanoparticles (AuNPs) triggered via the direct crosslinking reaction between creatinine and AuNPs, where an inexpensive laser pointer was used as a handheld light source and a smartphone as a portable device to record the TE phenomenon enhanced by the creatinine-induced aggregation of AuNPs. After evaluation and optimization of parameters such as AuNP concentrations and TE measurement time, the subsequent proof-of-concept experiments demonstrated that the average gray value change of TE images was linearly related to the logarithm of creatinine concentrations in the range of 1-50 μM, with a limit of detection of 0.084 μM. Meanwhile, our proposed creatinine sensing platform exhibited highly selective detection in complex matrix environments. Our approach offers a straightforward, cost-effective, and portable means of creatinine detection, presenting an encouraging signal readout mechanism suitable for point-of-care (POC) applications. The utilization of this assay as a POC solution exhibits potential for expediting timely interventions and enhancing healthcare outcomes among individuals with renal health issues.

Electrochemical detection of creatinine: exploiting copper(ii) complexes at Pt microelectrode arrays

This work develops a rapid and highly sensitive electrochemical sensor for creatinine detection at platinum microelectrode arrays (Pt-MEA). Copper(ii) ions are introduced to form the electroactive creatinine complex, which is then detected at Pt-MEA through a direct reduction reaction. Electrochemical behaviors of the creatinine complex are also explored at Pt macrodisc and microdisc electrodes in comparison with Pt-MEA. At the Pt-MEA, the linear range, sensitivity, and limit of detection of creatinine are determined to be 0.00-5.00 mM, 5401 ± 99 A m-2 M-1, and 0.059 mM (3SB/m), respectively. Notably, the Pt-MEA requires only 10 μL of sample and allows direct measurement of creatinine in synthetic urine with 97.39 ± 4.78% recovery.

Rapid Electrochemical Flow Analysis of Urinary Creatinine on Paper: Unleashing the Potential of Two-Electrode Detection

The development of low-cost, disposable electrochemical sensors is an essential step in moving traditionally inaccessible quantitative diagnostic assays toward the point of need. However, a major remaining limitation of current technologies is the reliance on standardized reference electrode materials. Integrating these reference electrodes considerably restricts the choice of the electrode substrate and drastically increases the fabrication costs. Herein, we demonstrate that adoption of two-electrode detection systems can circumvent these limitations and allow for the development of low-cost, paper-based devices. We showcase the power of this approach by developing a continuous flow assay for urinary creatinine enabled by an embedded graphenic two-electrode detector. The detection system not only simplifies sensor fabrication and readout hardware but also provides a robust sensing performance with high detection efficiencies. In addition to enabling high-throughput analysis of clinical urine samples, our two-electrode sensors provide unprecedented insights into the fundamental mechanism of the ferricyanide-mediated creatinine reaction. Finally, we developed a simplified circuitry to drive the detector. This forms the basis of a smart reader that guides the user through the measurement process. This study showcases the potential of affordable capillary-driven cartridges for clinical analysis within primary care settings.

Anodic SnO2 Nanoporous Structure Decorated with Cu2O Nanoparticles for Sensitive Detection of Creatinine: Experimental and DFT Study

Advanced anodic SnO₂ nanoporous structures decorated with Cu₂O nanoparticles (NPs) were employed for creatinine detection. Anodization of electropolished Sn sheets in 0.3 M aqueous oxalic acid electrolyte under continuous stirring produced complete open top, crack-free, and smooth SnO₂ nanoporous structures. Structural analyses confirm the high purity of rutile SnO₂ with successful functionalization of Cu₂O NPs. Morphological studies revealed the formation of self-organized and highly-ordered SnO₂ nanopores, homogeneously decorated with Cu₂O NPs. The average diameter of nanopores is ∼35 nm, while the average Cu₂O particle size is ∼23 nm. Density functional theory results showed that SnO₂@Cu₂O hybrid nanostructures are energetically favorable for creatinine detection. The hybrid nanostructure electrode exhibited an ultra-high sensitivity of around 24343 μA mM^-1 cm^-2 with an extremely lower detection limit of ∼0.0023 μM, a fast response time (less than 2 s), and wide linear detection ranges of 2.5-45 μM and 100 μM to 15 mM toward creatinine. This is ascribed to the creation of highly active surface sites as a result of Cu₂O NP functionalization, SnO₂ band gap diminution, and the formation of heterojunction and Cu(1)/Cu(ll)-creatinine complexes through secondary amines which occur in the creatinine structure. The real-time analysis of creatinine in blood serum by the fabricated electrode evinces the practicability and accuracy of the biosensor with reference to the commercially existing creatinine sensor. The proposed biosensor demonstrated excellent stability, reproducibility, and selectivity, which reflects that the SnO₂@Cu₂O nanostructure is a promising candidate for the non-enzymatic detection of creatinine.

Electrochemical creatinine detection for advanced point-of-care sensing devices: a review

Creatinine is an amino acid derived from creatine catabolism at different steps of the body's organs, and its detection is significant because levels out of normal values are linked to some diseases like kidney failure. Normal concentration levels of creatinine in blood are from 45 to 110 μM, while in urine, typical concentrations range between 3.3 to 27 mM, and in saliva from 8.8 and 26.5 μM. Nowadays, the creatinine detection is carried through different spectroscopic-colorimetric methods; however, the resulting values present errors due to high interferences, delayed analysis, and poor stability. Electrochemical sensors have been an alternative to creatinine detection, and the electrochemical methods have been adapted to detect in enzymatic and non-enzymatic sensors, the latter being more relevant in recent years. Nanomaterials have made creatinine sensors more stable, sensitive, and selective. This review presents recent advances in creatinine electrochemical sensors for advances in point-of-care (POC) sensing devices, comprising both a materials point of view and prototypes for advanced sensing. The effect of the metal, particle size, shape and other morphological and electronic characteristics of nanomaterials are discussed in terms of their impact on the effective detection of creatinine. In addition, the application of nanomaterials in POC devices is revised pointing to practical applications and looking for more straightforward and less expensive devices to manufacture.

Nanomaterial-Based Electrochemical Nanodiagnostics for Human and Gut Metabolites Diagnostics: Recent Advances and Challenges

Metabolites are the intermediatory products of metabolic processes catalyzed by numerous enzymes found inside the cells. Detecting clinically relevant metabolites is important to understand their physiological and biological functions along with the evolving medical diagnostics. Rapid advances in detecting the tiny metabolites such as biomarkers that signify disease hallmarks have an immense need for high-performance identifying techniques. Low concentrations are found in biological fluids because the metabolites are difficult to dissolve in an aqueous medium. Therefore, the selective and sensitive study of metabolites as biomarkers in biological fluids is problematic. The different non-electrochemical and conventional methods need a long time of analysis, long sampling, high maintenance costs, and costly instrumentation. Hence, employing electrochemical techniques in clinical examination could efficiently meet the requirements of fully automated, inexpensive, specific, and quick means of biomarker detection. The electrochemical methods are broadly utilized in several emerging and established technologies, and electrochemical biosensors are employed to detect different metabolites. This review describes the advancement in electrochemical sensors developed for clinically associated human metabolites, including glucose, lactose, uric acid, urea, cholesterol, etc., and gut metabolites such as TMAO, TMA, and indole derivatives. Different sensing techniques are evaluated for their potential to achieve relevant degrees of multiplexing, specificity, and sensitivity limits. Moreover, we have also focused on the opportunities and remaining challenges for integrating the electrochemical sensor into the point-of-care (POC) devices.

Electrochemical Biosensor for SARS-CoV-2 cDNA Detection Using AuPs-Modified 3D-Printed Graphene Electrodes

A low-cost and disposable graphene polylactic (G-PLA) 3D-printed electrode modified with gold particles (AuPs) was explored to detect the cDNA of SARS-CoV-2 and creatinine, a potential biomarker for COVID-19. For that, a simple, non-enzymatic electrochemical sensor, based on a Au-modified G-PLA platform was applied. The AuPs deposited on the electrode were involved in a complexation reaction with creatinine, resulting in a decrease in the analytical response, and thus providing a fast and simple electroanalytical device. Physicochemical characterizations were performed by SEM, EIS, FTIR, and cyclic voltammetry. Square wave voltammetry was employed for the creatinine detection, and the sensor presented a linear response with a detection limit of 0.016 mmol L-1. Finally, a biosensor for the detection of SARS-CoV-2 was developed based on the immobilization of a capture sequence of the viral cDNA upon the Au-modified 3D-printed electrode. The concentration, immobilization time, and hybridization time were evaluated in presence of the DNA target, resulting in a biosensor with rapid and low-cost analysis, capable of sensing the cDNA of the virus with a good limit of detection (0.30 µmol L-1), and high sensitivity (0.583 µA µmol-1 L). Reproducible results were obtained (RSD = 1.14%, n = 3), attesting to the potentiality of 3D-printed platforms for the production of biosensors.

Conventional and nanotechnology based sensors for creatinine (A kidney biomarker) detection: A consolidated review

There is an increasing demand for developing the novel methods for the detection of clinically important metabolites. One among those metabolites is creatinine (2-amino-1-methyl-5H-imidazol-4-one), a waste product, produced by the catabolism of phosphocreatine from muscle and protein metabolism, finally excreted by the kidney. It is very important to measure the creatinine level in human blood and urine because it reflects the muscular and thyroid functions. Importantly, the elevated level of creatinine is considered to be as impairment of the kidney. There are numerous methods existed to measure the concentration of creatinine in blood and urine. In this review, we consolidated the different conventional methods (chromatography, spectroscopy, immune sensor and enzyme-based detections) and their shortcomings. On other hand, we also dissertated the various nanomaterials (chemiluminescence, voltametric, amperometric, conductometric, potentiometric, impedimetric and nano polymer) based creatinine detection methods and their advantages. Finally, we also focussed on the point-of-care detection methods of creatinine determination. This review can conclude the low cost, more efficient and reliable new sensors have been developed with upgraded nanotechnology for the detection of creatinine.

Facile Detection of Blood Creatinine Using Binary Copper-Iron Oxide and rGO-Based Nanocomposite on 3D Printed Ag-Electrode under POC Settings

Metal nanoparticles have been helpful in creatinine sensing technology under point-of-care (POC) settings because of their excellent electrocatalyst properties. However, the behavior of monometallic nanoparticles as electrochemical creatinine sensors showed limitations concerning the current density in the mA/cm² range and wide detection window, which are essential parameters for the development of a sensor for POC applications. Herein, we report a new sensor, a reduced graphene oxide stabilized binary copper-iron oxide-based nanocomposite on a 3D printed Ag-electrode (Fe-Cu-rGO@Ag) for detecting a wide range of blood creatinine (0.01 to 1000 μM; detection limit 10 nM) in an electrochemical chip with a current density ranging between 0.185 and 1.371 mA/cm² and sensitivity limit of 1.1 μA μM^-1 cm^-2 at physiological pH. Interference studies confirmed that the sensor exhibited no interference from analytes like uric acid, urea, dopamine, and glutathione. The sensor response was also evaluated to detect creatinine in human blood samples with high accuracy in less than a minute. The sensing mechanism suggested that the synergistic effects of Cu and iron oxide nanoparticles played an essential role in the efficient sensing where Fe atoms act as active sites for creatinine oxidation through the secondary amine nitrogen, and Cu nanoparticles acted as an excellent electron-transfer mediator through rGO. The rapid sensor fabrication procedure, mA/cm² peak current density, a wide range of detection limits, low contact resistance including high selectivity, excellent linear response (R² = 0.991), and reusability ensured the application of advanced electrochemical sensor toward the POC creatinine detection.

Colorimetric Detection Based on Localized Surface Plasmon Resonance for Determination of Chemicals in Urine

Colorimetric sensors based on localized surface plasmon resonance (LSPR) have attracted much attention for biosensor and chemical sensor applications. The unique optical effect of LSPR is based on the nanostructure of noble metals (e.g., Au, Ag, and Al) and the refractive index of the environment surrounding these metal nanomaterials. When either the structure or the environment of these nanomaterials is changed, their optical properties change and can be observed by spectroscopic techniques or the naked eye. Colorimetric-probe-based LSPR provides a simple, rapid, real-time, nonlabelled, sensitive biochemical detection and can be used for point-of-care testing as well as rapid screening for the diagnosis of various diseases. Gold and silver nanoparticles, which are the two most widely used plasmonic nanomaterials, demonstrate strong and sensitive LSPR signals that can be used for the selective detection of several chemicals in biochemical compounds provided by the human body (e.g., urine and blood). This information can be used for the diagnosis of several human health conditions. This paper provides information regarding colorimetric probes based on LSPR for the detection of three major chemicals in human urine: creatinine, albumin, and glucose. In addition, the mechanisms of selective detection and quantitative analysis of these chemicals using metal nanoparticles are discussed along with colorimetric-detection-based LSPR for many other specific chemicals that can be detected in urine, such as catecholamine neurotransmitters, thymine, and various medicines. Furthermore, issues regarding the use of portable platforms for health monitoring with colorimetric detection based on LSPR are discussed.

For what factors should we normalize urinary extracellular mRNA biomarkers?

mRNA is a critical biomolecule involved in the manifestation of the genetic code into functional protein molecules. Its critical role in the central dogma has made it a key target in many studies to determine biomarkers and drug targets for numerous diseases. Currently, there is a growing body of evidence to suggest that RNA molecules around the size of full-length mRNA transcripts can be assayed in the supernatant of human urine and urinary extracellular mRNA could provide information about transcription in cells of urogenital tissues. However, the optimal means of normalizing these signals is unclear. In this paper, we describe relevant first principles as well as research findings from our lab and other labs toward normalization of urinary extracellular mRNA.

Modern creatinine (Bio)sensing: Challenges of point-of-care platforms

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.

Enzyme-less sensing of the kidney dysfunction biomarker creatinine using an inulin based bio-nanocomposite

Enzyme-less electrochemical sensing of creatinine using an inulin-based bio-nanocomposite.

Picric acid capped silver nanoparticles as a probe for colorimetric sensing of creatinine in human blood and cerebrospinal fluid samples

A new approach has been proposed for the traditional Jaffe's reaction by coating Ag NPs with picric acid to form an assembly that can selectively detect creatinine. This sensor proficiently and selectively recognizes creatinine due to the ability of picric acid to bind with it and form a complex.

In vitro concentration dependent detection of creatinine: a surface enhanced Raman scattering and fluorescence study

(a) SERS spectra and (b) fluorescence spectra of Jaffe complex showing consistent variation relatable to the concentration of CRN.

Two low-cost digital camera-based platforms for quantitative creatinine analysis in urine

In clinical analysis creatinine is a routine biomarker for the assessment of renal and muscular dysfunctions. Although several techniques have been proposed for a fast and accurate quantification of creatinine in human serum or urine, most of them require expensive or complex apparatus, advanced sample preparation or skilled operators. To circumvent these issues, we propose two home-made platforms based on a CD Spectroscope (CDS) and Computer Screen Photo-assisted Technique (CSPT) for the rapid assessment of creatinine level in human urine. Both systems display a linear range (r(2) = 0.9967 and 0.9972, respectively) from 160 μmol L(-1) to 1.6 mmol L(-1) for standard creatinine solutions (n = 15) with respective detection limits of 89 μmol L(-1) and 111 μmol L(-1). Good repeatability was observed for intra-day (1.7-2.9%) and inter-day (3.6-6.5%) measurements evaluated on three consecutive days. The performance of CDS and CSPT was also validated in real human urine samples (n = 26) using capillary electrophoresis data as reference. Corresponding Partial Least-Squares (PLS) regression models provided for mean relative errors below 10% in creatinine quantification.

Forensic electrochemistry: indirect electrochemical sensing of the components of the new psychoactive substance “Synthacaine”

For the first time a novel indirect, independently validated, electrochemical protocol for the sensing of MPA and 2-AI (“Synthacaine”) is reported.