BUN

Also known as: Urea nitrogen; Urea Formal name: Blood Urea Nitrogen Related tests: Creatinine; Creatinine Clearance; eGFR; CMP; BMP; Urinalysis; Microalbumin
How is it used?

The blood urea nitrogen or BUN test is primarily used, along with the creatinine test, to evaluate kidney function in a wide range of circumstances, to help diagnose kidney disease, and to monitor patients with acute or chronic kidney dysfunction or failure. It also may be used to evaluate a persons general health status when ordered as part of a basic metabolic panel (BMP) or comprehensive metabolic panel (CMP). ^ Back to top
When is it ordered?

BUN is part of both the BMP and CMP, groups of tests that are widely used:
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When someone has non-specific complaints As part of a routine testing panel To check how the kidneys are functioning before starting to take certain drug therapies When an acutely ill person comes to the emergency room and/or is admitted to the hospital During a hospital stay

BUN is often ordered with creatinine when kidney problems are suspected. Some signs and symptoms of kidney dysfunction include:
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Fatigue, lack of concentration, poor appetite, or trouble sleeping Swelling or puffiness (edema), particularly around the eyes or in the face, wrists, abdomen, thighs, or ankles Urine that is foamy, bloody, or coffee-colored A decrease in the amount of urine Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night Mid-back pain (flank), below the ribs, near where the kidneys are located High blood pressure

BUN also may be ordered:

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At regular intervals to monitor kidney function in patients with chronic diseases or conditions such as diabetes, congestive heart failure, and myocardial infarction (heart attack)

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At regular intervals to monitor kidney function and treatment in patients with known kidney disease Prior to and during certain drug treatments to monitor kidney function At regular intervals to monitor the effectiveness of dialysis.

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What does the test result mean?

Increased BUN levels suggest impaired kidney function. This may be due to acute or chronic kidney disease, damage, or failure. It may also be due to a condition that results in decreased blood flow to the kidneys, such as congestive heart failure, shock, stress, recent heart attack, or severe burns, to conditions that cause obstruction of urine flow, or to dehydration. BUN concentrations may be elevated when there is excessive protein breakdown (catabolism), significantly increased protein in the diet, or gastrointestinal bleeding (because of the proteins present in the blood). Low BUN levels are not common and are not usually a cause for concern. They may be seen in severe liver disease, malnutrition, and sometimes when a patient is overhydrated (too much fluid volume), but the BUN test is not usually used to diagnose or monitor these conditions. Both decreased and increased BUN concentrations may be seen during a normal pregnancy. If one kidney is fully functional, BUN concentrations may be normal even when significant dysfunction is present in the other kidney. NOTE: The result of your BUN test is measured by your doctor against a reference range for the test to determine whether the result is normal (it is within the range of numbers), high (it is above the high end of the range), or low (it is below the low end of the range). Because there can be many variables that affect the determination of the reference range, the reference range for this test is specific to the lab where your test sample is analyzed. For this reason, the lab is required to report your results with an accompanying reference range. Typically, your doctor will have sufficient familiarity with the lab and your medical history to interpret the results appropriately While there is no such thing as a standard reference range for BUN, most labs will report a similar, though maybe not exactly the same, set of numbers as that included in medical textbooks or found elsewhere online. For this reason, we recommend that you talk with your doctor about your lab results. For general guidance only, we are providing the reference range for this test from the classic medical text, Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. For more information on reference ranges, please read Reference Ranges and What They Mean. ^ Back to top

Is there anything else I should know?

BUN levels can increase with the amount of protein in your diet. High-protein diets may cause abnormally high BUN levels while very low-protein diets can cause an abnormally low BUN.
1. What other tests are used with BUN to check how my kidneys are functioning? BUN and creatinine are the primary tests used to check how well the kidneys are able to filter waste products from your blood. Your doctor may also order electrolyte tests such as sodium and potassium, or calcium to help understand how your kidneys are functioning.

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2. How does BUN change with age? BUN levels increase with age. BUN levels in very young babies are about 2/3 of the levels found in healthy young adults, while levels in adults over 60 years of age are slightly higher than younger adults. Levels are also slightly higher in men than women.

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3. What is a BUN/Creatinine ratio? Occasionally, a doctor will look at the ratio between a person s BUN and blood creatinine to help them determine what is causing these concentrations to be higher than normal. The ratio of BUN to creatinine is usually between 10:1 and 20:1. An increased ratio may be due to a condition that causes a decrease in the flow of blood to the kidneys, such as congestive heart failure or dehydration. It may also be seen with increased protein, from gastrointestinal bleeding, or increased protein in the diet. The ratio may be decreased with liver disease (due to decrease in the formation of urea) and malnutrition.

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