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Blood Urea Nitrogen (BUN) Test

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Blood Urea Nitrogen (BUN) Test


What is the BUN test?


 


It stands for Blood Urea Nitrogen test. Naturally, it is used to conclude the absorption of urea and nitrogen in the blood of a person. The procedure of this test is very simple; the sample of blood is taken from upper forearm of the patient for testing. In few cases the sample blood will be drawn from different location. This test is performed to check the functioning of kidney.
Kidney plays a major role in cleaning of blood. Blood is the mode of transportation for hormones & nutrients to various body parts & also blood is used to clean the waste from these body parts. After these waste removed they passes into the urinary bladder and from here it exists from the body.  Kidney works throughout the day to remove the waste and pass them into the urinary bladder. If kidney stops functioning, BUN test will be performing to determine the fact.

The important thing to note is that BUN test result can be affected because of its interaction with several types of drugs. If the patients are going under such medications which can cause issues with blood sample than this medication can contaminates the result of BUN test. So patient should inform the physician about the medications he is going under before the BUN test performed, so the physician can stop those medicines which can affect BUN test results or physician can replace those medicines with other medicines which will less affects the BUN test result. As compared to other tests BUN test takes a very less time to perform. The patient can go home after the BUN test. The result of BUN test will be available after the blood sample gets tested in lab. During pregnancy BUN test can be performed only if it is advised by physician.
The normal test range of BUN is 7 & 21 mg/dl of blood. If the result come b/w the normal range than it seems that patient is healthy. If the BUN tests result is higher than normal range than it means patient have some kidney issues. The physician could also describe other medical circumstances that can root high or low BUN test levels.
BUN Test during Pregnancy:
The time difference between the conception & delivering of baby is around 9 months in human beings. During this time period there will be many changes come in fetus & it grows regularly. And to help fetus in growing the mother’s body also undergo many changes physically as well as in terms of hormones level. These changes may cause many medicine conditions like diabetes during pregnancy & issue with kidney functioning during pregnancy which was may not be present previously.
The procedure of BUN test during pregnancy is similar to the BUN test performed normally. During pregnancy BUN test is performed along with other tests to check out the patient’s health. Also in few cases if kidney of pregnant women is not functioning properly, BUN test will be performed.
As explained above kidney plays a major role in cleaning the blood & transferring the wastage to urinary bladder for removal. During pregnancy mother body is responsible to deliver the baby with clean blood and at this time if the kidney of mother will not function properly it may cause a risk to the baby to associates with toxic exposure. Hence the BUN test will gets performed during pregnancy to check the functioning of kidney and if BUN test comes negative than extra medication will be done to make kidney functioning properly.
This test just takes few minutes to perform. This test is done very often during pregnancy just to ensure that the health of pregnant women is maintained.
For amino acid metabolism & protein urea is the final degradation product. Proteins are broken down to amino acids and delaminated in protein catabolism. During this process ammonia gets formed which will be synthesized to urea in the liver and in this way the extra amount of nitrogen from human body will gets eliminated.

Increased BUN may be caused due to prerenal causes, renal causes  and postrenal causes.
BUN test helps in measuring the level of nitrogen in blood which is the result of urea metabolism. Because of protein break down in body urea gets generated. Urea gets formed in the liver & removed from body in the urine. If the kidney of patient is not functioning properly or large amount of protein is being used by the body than it will raise the BUN level & if patient is suffering from major liver disease it will drop the BUN level.
BUN: Creatinine

BUN test may be performed with blood creatinine test. The level of creatinine in blood determines how well  kidneys are functioning—a high creatinine level means kidneys are not functioning properly. BUN & creatinine tests performed together to figure out ratio of BUN to creatinine which helps the physicians in determining the problems like dehydration which causes an abnormal BUN & creatinine level.
For protein metabolism urea is the principal end product which forms in liver from ammonia & evacuated by the kidneys, urea constitutes 40% - 50% of the blood’s non protein nitrogen.
BUN helps in measuring the level of nitrogen in blood which comes from the waste product urea. During the process of protein breakage in the liver urea gets formed. Urea gets removed from body in urine. BUN test checks the kidneys functioning ability. BUN level of blood gets increased if kidneys become inefficient to remove the urea from the blood. BUN level gets decreased if the patient has any liver disease or his/her liver is damaged.
Most of the times BUN test may be performed with blood creatinine test. Creatinine test can also be used to determine the kidneys work status. If the creatinine level is high it means kidneys are not performing well. In this case BUN level and creatinine ration is determined to forecast conditions like dehydration.
Need Necessity of blood urea nitrogen test is in following conditions:

Blood Urea Nitrogen (BUN) Test

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Blood Urea Nitrogen (BUN) Test

What is the BUN test?

 

It stands for Blood Urea Nitrogen test. Naturally, it is used to conclude the absorption of urea and nitrogen in the blood of a person. The procedure of this test is very simple; the sample of blood is taken from upper forearm of the patient for testing. In few cases the sample blood will be drawn from different location. This test is performed to check the functioning of kidney.
Kidney plays a major role in cleaning of blood. Blood is the mode of transportation for hormones & nutrients to various body parts & also blood is used to clean the waste from these body parts. After these waste removed they passes into the urinary bladder and from here it exists from the body.  Kidney works throughout the day to remove the waste and pass them into the urinary bladder. If kidney stops functioning, BUN test will be performing to determine the fact.

The important thing to note is that BUN test result can be affected because of its interaction with several types of drugs. If the patients are going under such medications which can cause issues with blood sample than this medication can contaminates the result of BUN test. So patient should inform the physician about the medications he is going under before the BUN test performed, so the physician can stop those medicines which can affect BUN test results or physician can replace those medicines with other medicines which will less affects the BUN test result. As compared to other tests BUN test takes a very less time to perform. The patient can go home after the BUN test. The result of BUN test will be available after the blood sample gets tested in lab. During pregnancy BUN test can be performed only if it is advised by physician.
The normal test range of BUN is 7 & 21 mg/dl of blood. If the result come b/w the normal range than it seems that patient is healthy. If the BUN tests result is higher than normal range than it means patient have some kidney issues. The physician could also describe other medical circumstances that can root high or low BUN test levels.
BUN Test during Pregnancy:
The time difference between the conception & delivering of baby is around 9 months in human beings. During this time period there will be many changes come in fetus & it grows regularly. And to help fetus in growing the mother’s body also undergo many changes physically as well as in terms of hormones level. These changes may cause many medicine conditions like diabetes during pregnancy & issue with kidney functioning during pregnancy which was may not be present previously.
The procedure of BUN test during pregnancy is similar to the BUN test performed normally. During pregnancy BUN test is performed along with other tests to check out the patient’s health. Also in few cases if kidney of pregnant women is not functioning properly, BUN test will be performed.
As explained above kidney plays a major role in cleaning the blood & transferring the wastage to urinary bladder for removal. During pregnancy mother body is responsible to deliver the baby with clean blood and at this time if the kidney of mother will not function properly it may cause a risk to the baby to associates with toxic exposure. Hence the BUN test will gets performed during pregnancy to check the functioning of kidney and if BUN test comes negative than extra medication will be done to make kidney functioning properly.
This test just takes few minutes to perform. This test is done very often during pregnancy just to ensure that the health of pregnant women is maintained.
For amino acid metabolism & protein urea is the final degradation product. Proteins are broken down to amino acids and delaminated in protein catabolism. During this process ammonia gets formed which will be synthesized to urea in the liver and in this way the extra amount of nitrogen from human body will gets eliminated.

Increased BUN may be caused due to prerenal causes, renal causes  and postrenal causes.
BUN test helps in measuring the level of nitrogen in blood which is the result of urea metabolism. Because of protein break down in body urea gets generated. Urea gets formed in the liver & removed from body in the urine. If the kidney of patient is not functioning properly or large amount of protein is being used by the body than it will raise the BUN level & if patient is suffering from major liver disease it will drop the BUN level.
BUN: Creatinine



BUN test may be performed with blood creatinine test. The level of creatinine in blood determines how well  kidneys are functioning—a high creatinine level means kidneys are not functioning properly. BUN & creatinine tests performed together to figure out ratio of BUN to creatinine which helps the physicians in determining the problems like dehydration which causes an abnormal BUN & creatinine level.
For protein metabolism urea is the principal end product which forms in liver from ammonia & evacuated by the kidneys, urea constitutes 40% - 50% of the blood’s non protein nitrogen.
BUN helps in measuring the level of nitrogen in blood which comes from the waste product urea. During the process of protein breakage in the liver urea gets formed. Urea gets removed from body in urine. BUN test checks the kidneys functioning ability. BUN level of blood gets increased if kidneys become inefficient to remove the urea from the blood. BUN level gets decreased if the patient has any liver disease or his/her liver is damaged.
Most of the times BUN test may be performed with blood creatinine test. Creatinine test can also be used to determine the kidneys work status. If the creatinine level is high it means kidneys are not performing well. In this case BUN level and creatinine ration is determined to forecast conditions like dehydration.
Need Necessity of blood urea nitrogen test is in following conditions:

  • To determine kidneys normal functioning
  • To determine kidney disease degradation
  • To check the treatment of kidney disease
  • To figure out the existent dehydration level

BUN test tells the current functioning status of Kidneys & liver.
Level of urea nitrogen in blood is measure through BUN test. Ammonia produced through liver contains nitrogen — Body cells use this nitrogen after it break down proteins. In blood cells this nitrogen get syndicates with other elements like hydrogen, oxygen & carbon to form urea, called chemical waste product. Through bloodstream urea travels to kidneys from liver. Kidneys’ functioning well filters the urea and other waste products from blood.

 

Why BUN test is performed?

BUN test is mainly used, along with the creatinine test, to estimate kidney function in an extensive range of conditions, to help identify kidney disease, and to control patients with severe or enduring kidney dysfunction or failure. It also may be used to estimate a person’s common health status when ordered as part of a BMP or CMP.
BUN is part of both the BMP and CMP, groups of tests that are widely used:

  • When there is no specific complaint from patient
  • As routine check up
  • To check kidneys functioning status before any drug therapy started
  • In severe illness of any patient
  • While staying in the hospital

BUN is often ordered with creatinine when kidney problems are suspected. Some signs and symptoms of kidney dysfunction include:

  • Trouble sleeping, lack of concentration. Fatigue or poor appetite
  • Edema or swelling in the face or around the eyes, abdomen, ankles, thighs or wrists.
  • Coffee colored, foamy or bloody urine.
  • Less amount of urine
  • Facing problem while urinating like abnormal discharge or burning feeling or the frequency of urination gets changed especially at night.
  • Pain in the area where kidney is located
  • BP (High)

BUN also may be ordered:

  •  At frequent intervals to monitor the functions of kidney in patients suffering from chronic disease or conditions like heart attack, congestive heart failure & diabetes. At frequent intervals to monitor the functions of kidney in patients suffering from known kidney diseases.
  • To monitor the kidney function before taking or during medication.
  • To check the effectiveness of dialysis on regular intervals.

BUN meditations may be raised when there is extreme protein catabolism, knowingly amplified protein in the diet, or abdominal bleeding.
The increment & decrement of BUN level depends on the amount of protein consumption in diet. High protein diets cause high BUN level similarly low protein diets cause low BUN level.
Low BUN level is not commonly found & also not a point of concern. Low BUN level cause due to major liver diseases, malnutrition & the patients have a high fluid volume, but BUN test is not performed for such conditions generally.
Increment & decrement in BUN level is generally caused during normal pregnancy.
BUN concentration remains normal even one kidney is functioning well; dysfunction in other kidney doesn’t affect the BUN concentration.
Kidney diseases reduce the kidneys filtration capacity of urea from the blood which will results in high urea level in the blood. BUN test is also performed while child is having kidney dialysis to check how his/her dialysis is functioning.
BUN test is normally always used with creatinine test.
Purpose of BUN Test

  • For the confirmation of bacteremia.
  • To figure out the causes of organism in septicemia & bacteremia. To identify the cause of fever happen due to unknown origin.

Many factors are involved in when & how often the BUN test will be performed. The time period of the test will be decides on the basis of other test results or completion & treatment or procedure of other test. If any sign or symptom appear test can be become suggested or important to perform.
The age & gender plays a major role in deciding the time of test. Protracted or progressive circumstances may require ongoing monitoring through the use of lab tests. Situations that get worse and develop may also need regular monitoring.
If the patient have allergy from latex than he should tell the physician about this before he drawn a blood for sample. If any medication is going on for excessive bleeding than this should also be informed to the physician. Also the physician has the knowledge that if patient got fainted while drawing blood last time.

How is BUN test done?

Firstly the skin will be cleaned very well & after that a blood sample will be taken from a vein with a needle. The sample blood will be collected in a tube & sent to a lab for testing. In younger children, this test can be done with a lancet.
This test just takes few minutes & also there is no risk of getting hepatitis, AIDS or any other disease born from blood.
Before test consumption of few medicines should be avoided because some medicines cause high BUN level.

How to Prepare for the Test
If patient is going under any medication than this thing should be informed to the physician before the BUN test.
Drugs increases the BUN level is:


Thiazide diuretics

Rifampin

Polymyxin B

Triamterene

Spironolactone

Probenecid

Vancomycin

Tetracyclines

Propranolol

Penicillamine

Methotrexate

Guanethidine

Cisplatin

Carbamazepine

Amphotericin B

Neomycin

Methicillin

Furosemide

Chloral hydrate

Bacitracin

Aminoglycoside antibiotics

Methyldopa

Indomethacin

Colistin

Cephalosporins

Aspirin

Allopurinol

Drugs decreases the BUN levels are:


Streptomycin

Chloramphenicol

Don’t consume high protein diet before the BUN test.

What does BUN test result mean?

 

Results of the BUN test are measured in mg/dL in the USA and in mmol/Ltr rest of the world. A normal level for BUN is usually 8 - 24 mg/dL for adult men and 6 - 21 mg/dL  for adult women. However, BUN results differs by age, small children’s have different BUN level as compare to adults.
High BUN level i.e above 50 mg/dL indicates that kidney is not functioning well. But, high urea nitrogen can also cause due to urinary tract barrier, congestive heart failure or abdominal bleeding. I also get increased due to shock, fever, dehydration or burns. 



Lower BUN level is a symptom of liver disease. But it can also be caused due to low protein diet or high carbohydrate diet.
Higher or lower BUN result can be confirmed by physician by doing another urine or blood test.
If kidney damage is a point of concern than reason of damage should be treated first.  The blood pressure should be controls because it requires high medication. The permanent damage to kidney cannot be healed but with proper protection it can be prevented to get more damaged.
The normal BUN level for childrens above 2 year is 4 – 15 mg/dL. Normal level may varies from lab to lab. In child’s result report provided from lab also shows the normal value.
A normal value differs from lab to lab:

  • Normal level : 10 to 20 mg/dL
  • BUN: Creatinine for above 1 year = 10:20
  • Babies below 1 year of age = up to 30:1

If BUN to creatinine ratio is high then there may be unexpected kidney failure may be detected.

 

While taking a sample blood from vein there is very less chance of complications. Bruise or puncture is the normal thing happen at the site. Warm compression several times in a day is helpful in vein inflammation condition. People suffering from bleeding disorder can face the problem of continuous bleeding.


Normal Values

1-17 Yrs

> or = 18 Yr

Males

7 to 20 mg/dL

8 to 24 mg/dL

Females

7 to 20 mg/dL

6 to 21 mg/dL

Note: - Reference value for patients less than 1 year of age is not available.

Child’s BUN level may be higher than normal because:

  • Kidneys of child are not functioning properly.
  • Dehydration in child
  • High protein diet consuming by child.
  • Child is having bleeding in intestine or stomach.
  • Delivering of blood in body from heart is not enough.
  • Child is under shock due to accident or burns.
  • Urinary area of child is blocked.

If child is healthy but BUN level is low than it is not a point of concern. If child is sick & BUN level is low than it means:

  • Liver of child is not functioning properly.
  • Child is consuming low protein diet.
  • Nourishment of the child is not proper.
  • Consumption level of fluid by child is very high.
  • Muscle mass of child is very little.

The normal BUN level of child is 6 to 20 milligram per diluter.
Note: Normal values differ lab to lab; physician advice is required on every test result.
Interfering Factors

  • Due to careless handling of blood sample cells of blood gets damaged.
  • Use of INN possibly decreases the BUN level.
  • BUN level increases by nephrotoxicity due to methicillin, amphotericin B & aminoglycosides.

Complications: A blood gets collected at puncture site.
Precaution: Sample should be handled carefully so blood cells not get damaged.
BUN level may be higher than normal because:

  • Kidneys are not functioning properly.
  • Dehydration
  • Consumption of high protein diet.
  • Bleeding in intestine or stomach.
  • Delivering of blood in body from heart is not enough.
  • Patient is under shock due to accident or burns.
  • Urinary area of patient is blocked.


BUN level may be lower than normal because:

  • Liver is not functioning properly.
  • Consumption of low protein diet.
  • Nourishment is not proper.
  • Consumption of fluids in large amount.
  • Muscle mass is very little.

BUN measures the nitrogen level in blood generated from waste product urea.
High values

  • It means the kidney is not functioning properly. Kidney damage caused due to high BP or diabetes. It is also caused to blockage at urinary area or low circulation of blood to the kidneys because of heart failure or dehydration.
  • High BUN level can be caused due to some medications also. Physician should be informed about all the prescribed or non-prescribed drugs consumed by the patient.
  • High BUN level can be caused due to consumption of high protein diet, severe burns, Addison’s disease or from bleeding in abdominal area.
  • .

Low values

  • It may be caused due to consumption of low protein diet or due to any liver disease.
  • Overhydrating due to drinking excessive fluid also cause low BUN level.
  • As compare to men, women & children’s have low BUN level depends how their body break down protein.

What if the test result is not normal?

 

Take advice from the physician regarding the test results.

  • Ask physician if the test result is not normal.
  • If additional test is needed.
  • What the precautions should be taken to get back to normal result.
  • When the retest is needed.

Additional conditions under which the test may be done include:


Wilms' tumor

Prerenal azotemia

Medullary cystic kidney disease

Interstitial nephritis

Good pasture syndrome

Digitalis toxicity

Atheroembolic kidney disease

Secondary systemic amyloidosis

Membranoproliferative GN II

Arteriolar nephrosclerosis

Hepatorenal syndrome

Generalized tonic-clonic seizure

Diabetes

Alport syndrome

Primary amyloidosis

Membranoproliferative GN I

Lupus nephritis

HUS

Epilepsy

Dementia due to metabolic causes

Acute nephritic syndrome


Take advice from the physician regarding the test results of the child.

  • If additional test is required to the child.
  • Type of treatment needed to the child
  • When the retest for the child is needed.

Ask the physician that how & where the test result will be available. According to the test result follow up care will be done. Sometimes follow up will not be done after the test result or sometimes follow up will be suggested or made necessary. Need to contact to the physician for any question related to follow up.
What Affects the Test?
Reasons due to which having test is not possible or the result is not helpful are:

  • Consuming medicines like nafcillin, nebcin, kantrex, tetracycline antibiotics, fungizone & chloramphenicol.
  • Consuming diuretics, which cause dehydration.
  • BUN level increases as the person get older.
  • As compared to men, women & children have lower BUN level.

What to think about?

  • BUN test performs with creatinine test. These both test used together to find BUN:Creatinine.
  • BUN test will continuously be performed in the people have kidney dialysis. These levels are used to check the condition of a kidney.
  • For the people with severe kidney disease a glomerular filtration rate will be done continuously to check the functionality of kidney.

Refrences:-
http://www.cpnonline.org/CRS/CRS/pa_bunitest_pep.htm
http://www.medicalhealthtests.com/articles/344/blood-tests/bun-test.html
http://www.mayomedicallaboratories.com/test-catalog/print/81793
https://www.mountauburnhospital.org/body.cfm?xyzpdqabc=0&id=6&action=detail&AEProductID=HW_Knowledgebase&AEArticleID=aa36271
http://health.nytimes.com/health/guides/test/bun/overview.html
http://nursingcrib.com/medical-laboratory-diagnostic-test/blood-urea-nitrogen-bun/
http://www.healthizen.com/treatments-procedures/blood-urea-nitrogen.aspx
http://www.muschealth.com/lab/content.aspx?id=150061
http://www.mylabsa.com/bun-test.html

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