Objective To evaluate the diagnostic value of creatinine, as an indicator of glomerular filtration function injury. Methods MEDLINE, EMBASE and CBM-disc were searched from 1993 to 2003. Thirty four articles that described biomedical markers to indicate glomerular filtration function injury were selected according to specified inclusion criteria. These articles were evaluated systematically using SPSS, EXCEL, and RevMan software. Results The odds ratios of creatinine was 24.23. Areas under summarized receiver operator characteristic curve were 0.871. Selected articles were divided to groups for analysis according to diagnostic standards, such as inulin, iohexol, 125I-iothalamate, 51Cr-EDTA, 99mTc-DTPA and sodium thiosulfate. Inter-group analysis of creatinine was not statistically different (P=0.32). Intra-group analysis of inulin, 51Cr-EDTA, 99mTc-DTPA, and iohexol was not statistically different, P value were 0.61, 0.50, 0.36, 0.32, respectively. Intra-group analysis of 125I-iothalamate was statistically different (P=0.02). Selected articles were sub-grouped according to different analytic techniques of creatinine. Intra-group analysis by the Jaffe method was statistically different (P=0.03), intra-group analysis of enzymatic method was not statistically different (P=0.22). Conclusion The diagnostic value of creatinine was not qualified enough to indicate glomerular filtration function injury. Enzymatic methods are recommended to measure creatinine. Inulin or 51Cr-EDTA is suggusted to measure glomerular filtration rate in investigation of creatinine，and feedforward cohort is recommended to apply.