Asist. Dr.

Omeed Akbar Ali

Biochemistry Lab.

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Blood Urea Nitrogen (BUN)/Urea

§ It is the nitrogen part of the urea.

§ Urea nitrogen is synthesized mainly in the liver. It is mostly the end
product of protein metabolism.
§ Proteins cannot be stored in the body. Surplus amino acids are catabolized
for energy when these are in excess.

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Blood Urea Nitrogen (BUN)/ Urea Formation

§ Amino acids are converted into ammonia (NH3), CO2, H2O, and energy.
§ NH3, before it reaches a toxic level, is prevented by the conversion of the NH3 to urea.
§ Urea is synthesized in the liver by CO2 and ammonia (NH3).
§ CO2 and ammonia (NH3) are produced from the deamination of the amino acids in the
urea cycle.
§ The urea through blood goes to the kidney and is excreted in the urine.

§Urea in the blood is reported as Blood Urea Nitrogen (BUN).

§ For to calculate BUN from the total blood urea = 60/28 = 2.14
§ Now the value of blood urea nitrogen (BUN) will be: suppose
Blood urea = 100 mg/dL = 100/2.14 = 46.7 mg/dL.

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 Pathophysiology of BUN and Blood Urea

§ In normal conditions, urea clearance values parallel the glomerular filtration rate (GFR) at about 60% of it.

§ The BUN is directly related to the liver’s metabolic function and the kidneys’ excretory function.

üUrea production and BUN increase when more amino acids are metabolized in the liver.

§ This occurs with a high-protein diet, tissue breakdown, and/or decreased protein synthesis.

ü While urea and BUN production is reduced in case of low protein intake and severe liver disease.

§In chronic renal diseases, BUN correlates better with the symptoms than creatinine.

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Indications For BUN
Ø To assess renal function.

Ø As a routine test in the patient with dialysis.

Ø To assess liver function.

Ø This may be part of the routine test. In patients:

ü Has nonspecific symptoms.

ü Before some drug therapy.

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Normal BUN and Urea
• Urea
• 20-40 mg/dl
• BUN
• Blood urea nitrogen (BUN) = 10-20 mg /dl

• Children (BUN) = 5-18 mg/dl

• Newborn = 3-12 mg/dL

• Older people may have a higher level than adults.

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 Increased Urea (BUN) Azotemia seen in:

ØA level above 100 mg/dL is the critical value indicating severe renal dysfunction :
v Impaired Renal Function.
v Urinary Tract Obstruction.

Ø Prerenal causes:

• These are mostly due to decreased blood flow to the kidneys.

• Stress.
• Congestive heart failure and Myocardial infarction (CHF).
• Dehydration.
• Salt and water depletion.
• Excessive protein catabolism.
• Shock.
• Burn.
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Decreased Urea/BUN seen in:

§ Severe liver diseases (liver failure).

§ Malnutrition and a low protein diet.

§ Impaired absorption of Celiac disease.

§Increased utilization of protein for synthesis.

§ Anabolic hormones.

§ Malnutrition.

§ Some drugs that may cause a decrease in BUN include Dextrose infusion, Phenothiazine,
and Thymol.

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Precautions For Blood Urea Nitrogen (BUN)

• If there is Fluoride, that will inhibit the Urease reaction.

• Avoid hemolysis.
• Protein intake will affect BUN.
•The dehydrated patient will concentrate BUN and gives high value.
• Advanced pregnancy may increase the BUN level.
• Drugs increasing the BUN level are cephalosporin, indomethacin, gentamicin, polymyxin
B, rifampicin, bacitracin, neomycin, and tetracycline, thiazide diuretics, and aspirin.
• Some drugs that decrease the BUN level is streptomycin and chloramphenicol.

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Sample

o It is done on the serum of the patient.

o No special preparation is needed.

o This test can be done on a random sample.

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Thanks For Listening …

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