Non-protein

Nitrogen (NBN)
285 PHL
Non-protein Nitrogen
Major components of the NPN
Urea, uric acid, creatinine, creatine, amino acids &
ammonia

Importance:
Test for kidney function

NPN is now replaced by determination of blood urea
nitrogen (BUN) because:
1- Urea constitutes 45% of NPN
2- Urea is excreted by glomerular filtration and
partially reabsorbed through renal tubules





Urea
Urea is the end product of protein and
nucleic acids metabolism
- It is synthesized in liver from CO2 & NH3

Urea
Normal value
10 50 mg/dl
Clinical significance
BUN (Hyperuremia)
1-Pre-renal causes
- Renal blood flow (e.g. CHF &
dehydration)
- Protein catabolism (as in fever)
- High protein diet
- Corticosteroid drugs



Urea: Clinical significance

2-Renal causes
- Acute and chronic renal failure
- Glomerular nephritis
- Tubular necrosis
- Malignant hypertension
3- Post- Renal causes
- Urethral stones
- Tumors of bladder
- Prostate enlargement

Urea: Clinical significance
BUN (hypouremia)
Could be due to:
-Liver failure
-Malnutrition
-Overhydration
-Early stages of pregnancy
-Low protein diet


Uric acid

Uric acid is the final breakdown product of
purine metabolism
Normal value
Men : 2.5 -6 mg/dl
Women: 2 -5 mg/dl

Uric acid


Disease correlations
uric acid (Hyperuricemia)
Gout
Pregnancy toxemia
Chemotherapy
Chronic renal disease

Uric acid

uric acid (Hypourecimia)
Liver disease
Fanconis syndrome ( defective tubular
reabsorption disorder)
Uricosuric drugs e.g. salicylate

Creatinine

Creatinine is the internal anhydride derived
from dephosphorylation of creatine
phosphate

Creatinine
Normal value
Male: 0.7-1.36 mg/dl
Female: 0.6 1.13 mg/dl
Clinical significance
level of creatinine indicates abnormal renal
function