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Blood Urea Nitrogen
Blood urea nitrogen (BUN) is a medical test that measures the amount of urea nitrogen found in blood. The liver produces urea in the urea cycle as a waste product of the digestion of protein. Normal human adult blood should contain 6 to 20 mg/dL (2.1 to 7.1 mmol/L) of urea nitrogen. Individual laboratories will have different reference ranges as the assay used can vary between laboratories. The test is used to detect renal problems. It is not considered as reliable as creatinine or BUN/creatinine ratio blood studies. Interpretation BUN is an indication of renal (kidney) health. The normal range is 2.1–7.1 mmol/ L or 6–20 mg/ dL. The main causes of an increase in BUN are: high protein diet, decrease in glomerular filtration rate (GFR) (suggestive of kidney failure), decrease in blood volume (hypovolemia), congestive heart failure, gastrointestinal hemorrhage, fever, rapid cell destruction from infections, athletic activity, excessive muscle breakdown, and increased ...
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Urea
Urea, also known as carbamide, is an organic compound with chemical formula . This amide has two amino groups (–) joined by a carbonyl functional group (–C(=O)–). It is thus the simplest amide of carbamic acid. Urea serves an important role in the metabolism of nitrogen-containing compounds by animals and is the main nitrogen-containing substance in the urine of mammals. It is a colorless, odorless solid, highly soluble in water, and practically non-toxic ( is 15 g/kg for rats). Dissolved in water, it is neither acidic nor alkaline. The body uses it in many processes, most notably nitrogen excretion. The liver forms it by combining two ammonia molecules () with a carbon dioxide () molecule in the urea cycle. Urea is widely used in fertilizers as a source of nitrogen (N) and is an important raw material for the chemical industry. In 1828 Friedrich Wöhler discovered that urea can be produced from inorganic starting materials, which was an important conceptual milestone ...
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Hypovolemia
Hypovolemia, also known as volume depletion or volume contraction, is a state of abnormally low extracellular fluid in the body. This may be due to either a loss of both salt and water or a decrease in blood volume. Hypovolemia refers to the loss of extracellular fluid and should not be confused with dehydration. Hypovolemia is caused by a variety of events, but these can be simplified into two categories: those that are associated with kidney function and those that are not. The signs and symptoms of hypovolemia worsen as the amount of fluid lost increases. Immediately or shortly after mild fluid loss (from blood donation, diarrhea, vomiting, bleeding from trauma, etc.), one may experience headache, fatigue, weakness, dizziness, or thirst. Untreated hypovolemia or excessive and rapid losses of volume may lead to hypovolemic shock. Signs and symptoms of hypovolemic shock include increased heart rate, low blood pressure, pale or cold skin, and altered mental status. When these ...
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Chemical Pathology
Clinical chemistry (also known as chemical pathology, clinical biochemistry or medical biochemistry) is the area of chemistry that is generally concerned with analysis of bodily fluids for diagnostic and therapeutic purposes. It is an applied form of biochemistry (not to be confused with medicinal chemistry, which involves basic research for drug development). The discipline originated in the late 19th century with the use of simple chemical reaction tests for various components of blood and urine. In the many decades since, other techniques have been applied as science and technology have advanced, including the use and measurement of enzyme activities, spectrophotometry, electrophoresis, and immunoassay. There are now many blood tests and clinical urine tests with extensive diagnostic capabilities. Most current laboratories are now highly automated to accommodate the high workload typical of a hospital laboratory. Tests performed are closely monitored and quality controlled ...
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Urine Urea Nitrogen
Urine urea nitrogen (UUN) refers to a test that measures the urine urea to assess nitrogen balance. Chemical structure Urea nitrogen is the end product of breakdown of proteins in the body. In individuals with normal kidney and liver functions, urea is excreted via urine. Indication for testing By testing for UUN, clinicians can assess one's nitrogen balance. Calculating nitrogen balance is a useful tool in assessing adequacy of protein provision in clinical setting in: * Patients with questionable protein intake. * Patients with confirmed or suspected protein digestion and absorption problems. * Patients with increased metabolic demand due to catabolic disease status. * Patients on long-term enteral nutrition or parenteral nutrition. Calculation of nitrogen balance UUN is determined from 24-hour urine collection. Along with UUN, values for BUN, protein content of diet, enteral or parenteral nutrition, and notable outputs other than urine (gastric residual, fistula output, ...
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Urea Reduction Ratio
The urea reduction ratio (URR) is a dimensionless number used to quantify dialysis treatment adequacy. Definition URR = \frac \times 100\% Where: * Upre is the pre-dialysis urea level * Upost is the post-dialysis urea level Whereas the URR is formally defined as the urea reduction "ratio", in practice it is informally multiplied by 100% as shown in the formula above, and expressed as a percent. History and overview The URR was first popularized by Lowrie and Lew in 1991 as a method of measuring amount of dialysis that correlated with patient outcome. This method is very useful because of its simplicity. It permits easy monitoring of the amount of dialysis therapy delivered to individual patients, as well as across dialysis units, groups of units, states, regions, or countries, because monthly predialysis and postdialysis urea nitrogen values are routinely measured. It also permits quality control and improvement initiatives and regulatory oversight. ThUnited States Renal ...
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Standardized Kt/V
Standardized Kt/V, also std Kt/V, is a way of measuring (renal) dialysis adequacy. It was developed by Frank Gotch and is used in the United States to measure dialysis. Despite the name, it is quite different from Kt/V. In theory, both peritoneal dialysis and hemodialysis can be quantified with std Kt/V. Derivation Standardized Kt/V is motivated by the steady state solution of the mass transfer equation often used to approximate kidney function (equation ''1''), which is also used to define clearance. :V \frac = -K \cdot C + \dot \qquad(1) where *\dot is the mass generation rate of the substance - assumed to be a constant, i.e. not a function of time (equal to zero for foreign substances/drugs) mol/minor ol/s*t is dialysis time inor *V is the volume of distribution (total body water) or 3*K is the clearance L/minor 3/s*C is the concentration mol/Lor ol/m3(in the United States often g/mL From the above definitions it follows that \frac is the first derivative of conc ...
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Kt/V
In medicine, ''Kt/V'' is a number used to quantify hemodialysis and peritoneal dialysis treatment adequacy. *''K'' – dialyzer clearance of urea *''t'' – dialysis time *''V'' – volume of distribution of urea, approximately equal to patient's total body water In the context of hemodialysis, Kt/V is a pseudo-dimensionless number; it is dependent on the pre- and post-dialysis concentration (see below). It is ''not'' the product of ''K'' and ''t'' divided by ''V'', as would be the case in a true dimensionless number. In peritoneal dialysis, it isn't dimensionless at all. It was developed by Frank Gotch and John Sargent as a way for measuring the dose of dialysis when they analyzed the data from the National Cooperative Dialysis Study. In hemodialysis the US National Kidney Foundation ''Kt''/''V'' target is ≥ 1.3, so that one can be sure that the delivered dose is at least 1.2. In peritoneal dialysis the target is ≥ 1.7/week. Despite the name, ''Kt''/''V'' is quit ...
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Ornithine Transcarbamylase Deficiency
Ornithine transcarbamylase deficiency also known as OTC deficiency is the most common urea cycle disorder in humans. Ornithine transcarbamylase, the defective enzyme in this disorder is the final enzyme in the proximal portion of the urea cycle, responsible for converting carbamoyl phosphate and ornithine into citrulline. OTC deficiency is inherited in an X-linked recessive manner, meaning males are more commonly affected than females. In severely affected individuals, ammonia concentrations increase rapidly causing ataxia, lethargy and death without rapid intervention. OTC deficiency is diagnosed using a combination of clinical findings and biochemical testing, while confirmation is often done using molecular genetics techniques. Once an individual has been diagnosed, the treatment goal is to avoid precipitating episodes that can cause an increased ammonia concentration. The most common treatment combines a low protein diet with nitrogen scavenging agents. Liver transplant is cons ...
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Blood Values Sorted By Mass And Molar Concentration
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the circulatory system is also known as ''peripheral blood'', and the blood cells it carries, ''peripheral blood cells''. Blood is composed of blood cells suspended in blood plasma. Plasma, which constitutes 55% of blood fluid, is mostly water (92% by volume), and contains proteins, glucose, mineral ions, hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and blood cells themselves. Albumin is the main protein in plasma, and it functions to regulate the colloidal osmotic pressure of blood. The blood cells are mainly red blood cells (also called RBCs or erythrocytes), white blood cells (also called WBCs or leukocytes) and platelets (also called thrombocytes). The most abundant cells in vertebrate blo ...
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Syndrome Of Inappropriate Antidiuretic Hormone Secretion
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by excessive unsuppressible release of Vasopressin, antidiuretic hormone (ADH) either from the posterior pituitary gland, or an abnormal non-pituitary source. Unsuppressed ADH causes an unrelenting increase in solute-free water being returned by the tubules of the kidney to the venous circulatory system, circulation. The causes of SIADH are grouped into six categories: 1) central nervous system diseases that directly stimulate the hypothalamus, the site of control of ADH secretion; 2) various cancers that synthesize and secrete ectopia (medicine), ectopic ADH; 3) various lung diseases; 4) numerous drugs that chemically stimulate the hypothalamus; 5) inherited mutations; and 6) miscellaneous largely transient conditions. ADH is derived from a preprohormone precursor that is synthesized in cells in the hypothalamus and stored in vesicles in the posterior pituitary. ''Appropriate'' ADH secretion is r ...
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Catabolism
Catabolism () is the set of metabolic pathways that breaks down molecules into smaller units that are either oxidized to release energy or used in other anabolic reactions. Catabolism breaks down large molecules (such as polysaccharides, lipids, nucleic acids, and proteins) into smaller units (such as monosaccharides, fatty acids, nucleotides, and amino acids, respectively). Catabolism is the breaking-down aspect of metabolism, whereas anabolism is the building-up aspect. Cells use the monomers released from breaking down polymers to either construct new polymer molecules or degrade the monomers further to simple waste products, releasing energy. Cellular wastes include lactic acid, acetic acid, carbon dioxide, ammonia, and urea. The formation of these wastes is usually an oxidation process involving a release of chemical free energy, some of which is lost as heat, but the rest of which is used to drive the synthesis of adenosine triphosphate (ATP). This molecule acts as a way f ...
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Fever
Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between in humans. The increase in set point triggers increased muscle tone, muscle contractions and causes a feeling of cold or chills. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes Flushing (physiology), flushed, and may begin to Perspiration, sweat. Rarely a fever may trigger a febrile seizure, with this being more common in young children. Fevers do not typically go higher than . A fever can be caused by many medical conditions ranging from non-serious to life-threatening. This includes viral infection, viral, bacterial infection, bacterial, and parasitic infect ...
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