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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. Excreted by kidneys. • 1st metabolite to increase in kidney disease • BUN x 2.467 = BUN .357 • Urea CO (NH2)2 . Urea x 0. MW: 60 Da • Major end product of protein (dietary) and amino acid catabolism • Synthesized by liver from ammonia.14 = Urea.

1 mmol/L • Elderly patients ( 60 years): 8–23 mg/dL or 2.2 mmol/L • Children: 5–18 mg/dL or 1.Reference Values Normal • Adults: 6–20 mg/dL or 2.1–7.4 mmol/L • Normal BUN:Creat ratio = 10:1 – 20:1 .8–6.9–8.

Urine (24hr) – Should be analyzed w/in few hrs after collection or preserved by refrigeration (4°-8°C up to 72hrs.Procedure: Pre-analytical Considerations • Explain test purpose and blood drawing procedure to the patient • Patient is taking any medication • Specimen – Serum or Plasma. 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 .

Isotope Dilution Mass Spectrometry (IDMS) – reference method . Measurement of Ammonia is most often used. 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.Analytical Methods Enzymatic Method (Indirect Method) a.

5.Clinical Implications Increased BUN levels (azotemia) • Impaired renal function caused by 1. 2. Congestive heart failure Salt and water depletion Shock Stress Acute MI . 4. 3.

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 .

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

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

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