BUN-to-creatinine Ratio - Interpretation

Interpretation

Pathophysiology sample values
BMP/ELECTROLYTES:
Na+ = 140 Cl− = 100 BUN = 20 /
Glu = 150
K+ = 4 CO2 = 22 PCr = 1.0 \
ARTERIAL BLOOD GAS:
HCO3- = 24 paCO2 = 40 paO2 = 95 pH = 7.40
ALVEOLAR GAS:
pACO2 = 36 pAO2 = 105 A-a g = 10
OTHER:
Ca = 9.5 Mg2+ = 2.0 PO4 = 1
CK = 55 BE = −0.36 AG = 16
SERUM OSMOLARITY/RENAL:
PMO = 300 PCO = 295 POG = 5 BUN:Cr = 20
URINALYSIS:
UNa+ = 80 UCl− = 100 UAG = 5 FENa = 0.95
UK+ = 25 USG = 1.01 UCr = 60 UO = 800
PROTEIN/GI/LIVER FUNCTION TESTS:
LDH = 100 TP = 7.6 AST = 25 TBIL = 0.7
ALP = 71 Alb = 4.0 ALT = 40 BC = 0.5
AST/ALT = 0.6 BU = 0.2
AF alb = 3.0 SAAG = 1.0 SOG = 60
CSF:
CSF alb = 30 CSF glu = 60 CSF/S alb = 7.5 CSF/S glu = 0.4

Normal serum values

Test SI units US units
BUN (Urea) 7–20 mg/dL
Urea 2.5-10.7 mmol/L
Creatinine 62-106 μmol/L 0.7-1.2 mg/dL

Serum Ratios

BUN:Cr UNa Location Mechanism
>20:1 >100:1 Prerenal (before the kidney) BUN reabsorption is increased. BUN is disproportionately elevated relative to creatinine in serum. Dehydration is suspected.
10-20:1 40-100:1 Normal or Postrenal (after the kidney) Normal range. Can also be postrenal disease. BUN reabsorption is within normal limits.
<10:1 <40:1 Intrarenal (within kidney) Renal damage causes reduced reabsorption of BUN, therefore lowering the BUN:Cr ratio.

An elevated BUN:Cr due to a low or low-normal creatinine and a BUN within the reference range is unlikely to be of clinical significance.

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