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Background Uromodulin, also known as Tamm-Horsfall protein, is the most abundant protein in urine. It has recently been reported that uromodulin exists in a small amount in blood and that its concentration correlates with the estimated glomerular filtration rate (eGFR). However, its clinical significance has not been clarified and there are no relevant data for the Japanese population. Method First, we generated anti-human uromodulin mouse monoclonal antibodies and established a specific enzyme-linked immunosorbent assay for uromodulin. We then performed an observational clinical study to determine if there was a correlation between serum uromodulin concentration and estimates of kidney function and whether the serum uromodulin value could be a biomarker in clinical nephrology. The clinical study included 308 patients with and without chronic kidney disease and healthy volunteers. Serum concentrations of creatinine, cystatin C, and uromodulin were measured and correlations were sought between the eGFR calculated from the creatinine and cystatin C levels and the serum uromodulin concentration. Results There was a good correlation between the serum uromodulin concentration and the eGFR value calculated from the creatinine (r=0.76) and cystatin C (r=0.79) levels. The mean serum uromodulin level in the group with an eGFR >90 mL/min/1.73 m 2 calculated using cystatin C was significantly higher than that in the group with an eGFR of 80–89 mL/min/1.73 m 2 . Conclusions The serum uromodulin measurement could be a useful biomarker for identification of patients with early deterioration of kidney function.