BUN (Blood Urea Nitrogen)

and Creatinine
VIVIANA CADENA
 What are BUN and Creatinine? Test
Explanation
Urea and creatinine are nitrogenous end
products of metabolism.
Urea is the primary metabolite derived from
dietary protein and tissue protein turnover.
Therefore the BUN (Blood Urea Nitrogen) is
directly related to the metabolic function of the
liver and the excretory function of the kidney.
Creatinine is the product of muscle creatine
catabolism. which is used in skeletal muscle BUN and Creatinine are used to assess
contraction. Renal Function

https://www.ncbi.nlm.nih.gov/books/NBK305/
BUN and Creatinine
levels increase with
decreased kidney
function

Relationship of
blood urea
nitrogen or serum
creatinine to
glomerular
filtration rate.

https://www.ncbi.nlm.nih.gov/books/NBK305/
Normal Findings  Creatinine
 61 years and above:
 Female: 0.5–1.2 mg/dL
 BUN
 Male: 0.7–1.3 mg/dL
 Adult: 10–20 mg/dL or 3.6–7.1 mmol/L (SI
units)
 41 years to < 61 years:
 Female: 0.5–1.1 mg/dL
 Elderly: may be slightly higher than adult
 Male: 0.6–1.3 mg/dL
 Child / Infant: 5–18 mg/dL
 18 years to < 41 years:
 Newborn: 3–12 mg/dL
 Female: 0.5–1.0 mg/dL
 Cord: 21–40 mg/dL
 Male: 0.6–1.2 mg/d
 6 years to < 10 years: 0.3–0.6 mg/dL
 2 years to < 6 years: 0.2–0.5 mg/dL
 < than 2 years: 0.1–0.4 mg/dL
Critical value and Abnormal Findings
 BUN
 CRITICAL: > 100 mg/dL (indicates serious
impairment of renal function)
 Creatinine
 2.5 to 4.5 → Moderate Renal Failure
 5 to 9.9 → Severe Renal Failure
 10 or greater → End-Stage Renal Disease
 CRITICAL: > 4 mg/dL (indicates serious
impairment in renal function)
Interfering Factors

 BUN  CREATININE
 ↓ protein diets ↓ BUN if caloric intake is  A diet high in meat content can cause transient
maintained with carbohydrates. ↑ of serum creatinine.
 ↑ protein diets or tube feeding ↑ BUN levels.  Some drugs that may ↑ creatinine
 Muscle mass: Women and children have ↓  e.g ACE inhibitors
BUN levels than men.
 Advanced pregnancy may cause ↑ due to ↑
protein metabolism.
 GI bleeding can cause ↑ BUN levels.
 Some drugs may cause ↑ (e.g. furosemide) or
↓ (e.g. streptomycin) in BUN
 Procedure and Patient Care

 BUN and Creatinin

 Fasting: no
 Blood tube commonly used: red
BUN/Creatinine Ratio

The creatinine level is interpreted in conjunction with the BUN. These tests are
referred to as renal function studies:
the BUN/creatinine ratio is a good measurement of kidney and liver
function. The normal range is 6 to 25, with 15.5 being the optimal adult
value for this ratio.
References

• Hosten AO. BUN and Creatinine. In: Walker HK, Hall WD, Hurst JW, editors. Clinical
Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston:
Butterworths; 1990. Chapter 193. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK305/
• Pagana, K. D., & Pagana, T. J. (2017). Mosby’s manual of diagnostic and
laboratory tests (6th ed.). Mosby.