Step 1: Understanding the Concept
Creatinine is formed from muscle creatine at a steady rate and is cleared mainly by glomerular filtration.
Step 2: In acute renal failure
The filtration rate falls suddenly, so creatinine builds up in the serum along with urea.
Step 3: Why the other options fail
High ammonia points to liver failure and bile salts to liver or bile duct disease. Serum albumin tends to fall, not rise, in kidney disease.
Final Answer:
Acute renal failure shows as an elevated serum creatinine level.
\[ \boxed{\text{(D) }\text{Creatinine}} \]