Blood Urea Nitrogen Test

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Blood Urea Nitrogen
Test
Results Units Normal Ranges
20 mg/dL (7-22)
30 mg/dL (7-22)
4 mg/dL (7-22)
Prepared by:
Radwan Rushdi Mohammed

Contents
Blood Urea Nitrogen Test
Levels Of BUN
Causes Of BUN
Symptoms Of BUN
Diagnosing BUN
BUN/Creatinine Ratio
Data Collection
A Case Study For BUN
Treatments
Prevention

Blood Urea Nitrogen
Blood urea nitrogen (BUN):
is a measure of the amount of urea
nitrogen's in the blood
The liver produces urea as a waste product of proteins
breakdown. It binds excess nitrogen from used-up
proteins and safely removes it from the body
5 enzymes take part to produces urea
This test is ordered to check if kidneys are working
normally or if kidney disease is progressing
*You can get the reference of this slide
by scanning this QR code
CO(NH2)2

Levels of BUN
Approximately normal levels of
Serum/plasma urea is 2.5-7.8 mmol/L and for
Serum/plasma BUN is 7.0-22 mg/dL
BUN levels represent the balance between:
Urea production (in the liver)
Urea breakdown
Urea elimination (via the kidneys)
Therefore, BUN is an indicator of kidney health
and/or liver health.
*Scan for slide reference
0
10
20
30
10 15 20 30 40 50 60 70 80 90 100
BUN with age
male female

Causes of BUN
*Download the reference(PDF file) of
this slide by scanning this QR code
- Chronic, severe liver disease
- Low protein diets
- Drugs causing diuresis
- Overhydration
- Increased protein synthesis
• Prerenal
- Hypovolemia/blood loss
- Dehydration
- Recent high protein meal
- Gastrointestinal hemorrhage
• Renal
- Infectious
- Inflammatory
• Post renal
- Bladder, urethral or ureteral rupture
- Ureteral or urethral obstruction
3 places which if they were abnormal
can lead to increase BUN which are:
Decreased BUN Increased BUN

Symptoms of BUN
Decreased BUN Increased BUN
Decreased BUN symptoms include
liver disease symptoms such as:
- jaundice
- Fatigue
- Diarrhea
- Swelling lower legs
Increased BUN may cause you to have
some of the following symptoms:
- Extreme tiredness or fatigue
- Cramping in your legs
- Little or no appetite
- Headache
- Nausea
- Vomiting
- Trouble concentrating

Diagnosing BUN
*slide information is obtained from the site that you
can access it by scanning this QR code
Is done by instruments
such as Cobas C111 which
gives you a direct result
(Its procedure is shown in
this GIF)
Is done by instruments such as
a spectrophotometer
which you get the result by
reading the absorbances
BUN test starts with a blood drawing from the
patient collected in a yellow top tube then
centrifuged to collect serum, we can do the test in
two methods which are manually or automatically

Diagnosing BUN Manually
*Download the reference(PDF file)
of this slide by scanning this QR
code
Manually diagnosing BUN is based on the principle of hydrolyzing urea by
urease to give ammonia, which reacts with 2-oxoglutarate and the
reduced cofactor in the presence of the enzyme glutamate dehydrogenase
(GLDH) to yield an oxidized cofactor. The resulting decrease in color due to
the reduction of the cofactor is monitored spectrophotometrically at 340
nm and is directly proportional to the urea in the sample.

BUN/Creatinine Ratio
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, gastrointestinal bleeding, or increased protein in the diet.
An increased ratio:
The ratio may be decreased with liver
disease (due to a decrease in the
formation of urea) and malnutrition.
A decreased ratio:
The normal BUN/Creatinine ratio
is 10-20 to 1
Increased BUN
Normal Creatinine
Renal decreased BUN / Creatinine ratio
Low dietary protein or severe liver disease
Pre-renal increased BUN / Creatinine ratio
BUN is more susceptible to non-renal factors
Increased BUN
Increased Creatinine
Post-renal increased ratio BUN/ Creatinine ratio
Both BUN and Creatinine are elevated
Decreased BUN
Normal Creatinine

Treatments & Prevention
*You can get the reference of this
slide by scanning this QR code
o Treat causative factors
(High blood pressure - Infections - Nephrostomy tube)
o Hydration
o Renal replacement therapy
o Pharmacological treatment
o Dialysis if necessary
o Strict intake output chart
o Initiate infection control measures.
o Skincare
o Limit protein and provide adequate
carbohydrates.
Prevention:
Treatments:
ACEI or ARB + diuretics
(enalapril or valsartan plus hydrochlorothiazide)
Vitamin K supplements
Oral rehydration solutions
Ceftriaxone

Data collection For BUN Test
*You can access through the name of the labs
and their places(But not in English)
by scanning this QR code
The data that I collected was based on which
gender is more likely is affected by the BUN test
and also their ages, diagnosis techniques & the
prices are included
- Data is collected by visiting 40 laboratories
- A form is filled out by the lab technicians
- The form consists of 8 questions
- Results are mentioned in the other slide

2
7
6
15
7
1 2
Price-IQD
2000 3000 4000 5000 7000 8000 10000
75%
25%
Gender

4
6
10
14
30
23
0
5
10
15
20
25
30
35
Age
Age Average
< 10 10-18 19 - 24 25 - 35 36 - 49 > 50
37 3
0 5 10 15 20 25 30 35 40
Method
Diagnosis
Automatically
Manually

BUN Clinical Case Study
*This case is based on
real-life research you
can access the research
by scanning this QR
code
A 53-year-old African-American male presented to the emergency room (ER) with complaints of
nausea and vomiting for 2 months, shortness of breath for the last few days, altered taste
sensation, and worsening preexisting lower extremity swelling.
Other complaints included blurred vision, diarrhea, and extreme weakness. Social History
includes no tobacco use and occasional alcohol use. Pertinent physical examination findings
were significant for lower extremity edema up to the knees, and the presence of fine white
crystals distributed in patches on the head and neck (pictures are shown below)
Test results that he made are shown in the other slide.

BUN Clinical Case Study
*This case is based on real-life research
you can access the research by scanning
this QR code
NOTE: Those results that are underlined( ) under the numbers refer to an abnormal result

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Blood Urea Nitrogen Test

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