Blood urea nitrogen
| Blood urea nitrogen | |
|---|---|
 | |
| MeSH | D001806 |
| LOINC | 6299-2, 59570-2, 12961-9, 12963-5, 12962-7 |
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 between 6 and 20 mg of urea nitrogen per 100 ml (6–20 mg/dL) of blood. Individual laboratories will have different reference ranges as the assay used will vary between laboratories.[1][2]
Interpretation
Blood urea nitrogen (BUN) is an indication of renal (kidney) health. The normal range is 1.8-7.1 mmol/L or 6–20 mg/dL. Blood urea nitrogen levels can also help identify damage to body systems and diseases of the digestive, circulatory and respiratory systems. [3]
The main causes of an increase in BUN are: high protein diet, decrease in glomerular filtration rate (GFR) (suggestive of renal failure) and in blood volume (hypovolemia), congestive heart failure, gastrointestinal hemorrhage,[4] fever and increased catabolism. Hypothyroidism can cause both decreased GFR and hypovolemia, however BUN-to-creatinine ratio 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.[4]
Another rare cause of a decreased BUN is ornithine transcarbamylase deficiency, 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 as mmol/L, generally depending on the lab.
BUN (urea-N) SI unit is mmol/L
BUN [mmol/L] = BUN [mg/dL] * 0.3571
To convert from mg/dL of blood urea nitrogen to mmol/L of urea, multiply by 0.357 (each molecule of urea having 2 nitrogens, each of molar mass 14g/mol) (BUN is the mass of nitrogen within urea/volume, not the mass of urea)
- Urea [mmol/L] = BUN [mg/dL of nitrogen] x 10 [dL/L] / 14x2 [mg N/mmol urea] (the mass of nitrogen within urea is used)
convert BUN to urea in mg/dL by using following formula:
- Urea [mg/dL]= BUN [mg/dL] * 2.14
(conversion factor derived by: MW of urea = 60, MW of urea nitrogen = 14x2 => 60/28 = 2.14)
factor = 1 for conversions in mmol (1 mole N2 = 2 moles N per mole of urea):
- BUN [mmol/L]= urea [mmol/L]
See also
References
- ^ Last page of Deepak A. Rao; Le, Tao; Bhushan, Vikas (2007). First Aid for the USMLE Step 1 2008 (First Aid for the Usmle Step 1). McGraw-Hill Medical. ISBN 0-07-149868-0.
- ^ Normal Lab Results Archived December 16, 2014, at the Wayback Machine from Marshal University School of Medicine
- ^ "Blood Urea Nitrogen". biologydictionary.net. Retrieved 11 July 2017.
- ^ a b Longo et al., Harrison's Principles of Internal Medicine, 18th ed., p.611