Ares, Bea Claire

Gayam, Glydenne Glaire

Blood Urea Nitrogen (BUN)

Urea Nitrogen measurement of the
amount of urea nitrogen in the blood
Conversion Factor: 0.357
Urea CO (NH2)2 ; MW: 60 Da
Major end product of protein (dietary) and
amino acid catabolism
Synthesized by liver from ammonia.
Excreted by kidneys.
1st metabolite to increase in kidney disease
BUN x 2.14 = Urea; Urea x 0.467 = BUN

Reference Values
Normal
Adults: 620 mg/dL or 2.17.1 mmol/L
Elderly patients ( 60 years): 823
mg/dL or 2.98.2 mmol/L
Children: 518 mg/dL or 1.86.4 mmol/L

Normal BUN:Creat ratio = 10:1 20:1

Procedure: Pre-analytical Considerations

Explain test purpose and blood drawing
procedure to the patient
Patient is taking any medication
Specimen
Serum or Plasma; Urine (24hr)
Should be analyzed w/in few hrs after collection or
preserved by refrigeration (4-8C up to 72hrs,
ph<4)

Anticoagulants containing fluoride (gray-top

evacuated tubes) or citrate should be avoided

Procedure: Pre-analytical Considerations

Fasting sample not required

Non-hemolyzed sample
No interferences from biliribun &
lipemia
Thiosemicarbazide and Ferric ions
are added

Analytical Methods
Chemical Method (Direct Method)
Diacetyl Monoxime Method
Urea + DAM Yellow Diazine
Derivative

Analytical Methods
Enzymatic Method (Indirect Method)
a. Hydrolysis of Urea by Urease

Urea + Urease NH3 + CO2

Ammonia produced treated w/ Berthelot Reagents
NH3 & CO2 : measured by various methods to
calculate urea in original sample. Measurement of
Ammonia is most often used.

Isotope Dilution Mass Spectrometry (IDMS)

reference method

Clinical Implications
Increased BUN levels (azotemia)
Impaired renal function caused by
1.
2.
3.
4.
5.

Congestive heart failure

Salt and water depletion
Shock
Stress
Acute MI

Clinical Implications
Increased BUN levels (azotemia)
Chronic renal disease such as
glomerulonephritis and pyelonephritis
Urinary tract obstruction
Hemorrhage into GI tract
Diabetes mellitus with ketoacidosis
Excessive protein intake or protein
catabolism as occurs in burns or cancer
Anabolic steroid use

Clinical Implications
Decreased BUN levels
Liver failure (severe liver disease),
such as that resulting from hepatitis,
drugs, or poisoning
Acromegaly
Impaired absorption (celiac disease)
Nephrotic syndrome (occasional)
Syndrome of inappropriate
antidiuretic hormone (SIADH)

Interfering Factors
1. Combination of a low-protein and highcarbohydrate diet can cause a decreased BUN
level.
2. BUN is normally lower in children and women
because they have less muscle mass than
adult men.
3. Decreased BUN values normally occur in late
pregnancy because of increased plasma
volume (physiologic hydremia).
4. Older persons may have an increased BUN
when their kidneys are not able to concentrate
urine adequately.
5. IV feedings only may result in overhydration

END

Give up trying to do everything myself and depended on Him even for the
smallest of things.