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Blood urea nitrogen (BUN) is a medical test that measures the amount of urea nitrogen found in blood. The liver produces
Another rare cause of a decreased BUN is
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 r ...
in the urea cycle
The urea cycle (also known as the ornithine cycle) is a cycle of biochemical reactions that produces urea (NH2)2CO from ammonia (NH3). Animals that use this cycle, mainly amphibians and mammals, are called ureotelic.
The urea cycle converts highl ...
as a waste product of the digestion
Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...
of protein
Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, respo ...
. Normal human adult blood
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 c ...
should contain 6 to 20 mg/dL (2.1 to 7.1 mmol/L) of 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 r ...
nitrogen
Nitrogen is the chemical element with the symbol N and atomic number 7. Nitrogen is a nonmetal and the lightest member of group 15 of the periodic table, often called the pnictogens. It is a common element in the universe, estimated at se ...
. Individual laboratories will have different reference range
In medicine and health-related fields, a reference range or reference interval is the range or the interval of values that is deemed normal for a physiological measurement in healthy persons (for example, the amount of creatinine in the blood, or ...
s as the assay used can vary between laboratories. The test is used to detect renal problems. It is not considered as reliable as creatinine
Creatinine (; ) is a breakdown product of creatine phosphate from muscle and protein metabolism. It is released at a constant rate by the body (depending on muscle mass).
Biological relevance
Serum creatinine (a blood measurement) is an import ...
or BUN/creatinine ratio blood studies.
Interpretation
BUN is an indication ofrenal
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
(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
Renal functions include maintaining an acid–base balance; regulating fluid balance; regulating sodium, potassium, and other electrolytes; clearing toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood p ...
(GFR) (suggestive of kidney failure
Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
), decrease in blood volume (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 los ...
), congestive heart failure
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...
, gastrointestinal hemorrhage, 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 ...
, rapid cell destruction from infections, athletic activity, excessive muscle breakdown, and increased 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, ...
.
Hypothyroidism can cause both decreased GFR and hypovolemia, but BUN-to-creatinine ratio
In medicine, the BUN-to-creatinine ratio is the ratio of two serum laboratory values, the blood urea nitrogen (BUN) (mg/dL) and serum creatinine (Cr) (mg/dL). Outside the United States, particularly in Canada and Europe, the term urea is often us ...
has been found to be lowered in hypothyroidism and raised in hyperthyroidism.
The main causes of a decrease in BUN are severe liver disease, anabolic state, and syndrome of inappropriate antidiuretic hormone
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by excessive unsuppressible release of antidiuretic hormone (ADH) either from the posterior pituitary gland, or an abnormal non-pituitary source. Unsuppressed ADH c ...
.
Another rare cause of a decreased BUN is 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, re ...
, which is a genetic disorder inherited in an X-linked recessive pattern. OTC deficiency is also accompanied by hyperammonemia and high orotic acid levels.
Units
BUN (urea-N) is mg/dL in the United States, Mexico, Italy, Austria, and Germany. Elsewhere, the concentration of urea is reported in SI unit as mmol/L, which is generally depending on the lab. represents the mass of nitrogen within urea/volume, not the mass of whole urea. Each molecule of urea has two nitrogen atoms, each of molar mass 14g/mol. To convert from mg/dL of blood urea nitrogen to mmol/L of urea: Note that molar concentrations of urea and urea nitrogen are equal, because both nitrogen gas and urea has two nitrogen atoms. Convert BUN to urea in mg/dL by using following formula: Where 60 represents MW of urea and 14*2 MW of urea nitrogen.See also
*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 ...
* 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 perito ...
* 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 ...
* 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 ...
References
{{DEFAULTSORT:Blood Urea Nitrogen Chemical pathology Nitrogen cycle Nephrology