Blood urea nitrogen
|Blood urea nitrogen|
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Blood urea nitrogen (BUN) is a medical test that measures the amount of urea nitrogen found in blood. The liver produces urea in the urea cycle as a waste product of the digestion of protein. Normal human adult blood should contain 7 to 20 mg/dL (2.5 to 7.1 mmol/L) of urea nitrogen. Individual laboratories will have different reference ranges as the assay used can vary between laboratories.
The main causes of an increase in BUN are: high protein diet, decrease in glomerular filtration rate (GFR) (suggestive of renal failure), decrease in blood volume (hypovolemia), congestive heart failure, gastrointestinal hemorrhage, fever, and increased catabolism. Hypothyroidism can cause both decreased GFR and hypovolemia, but BUN-to-creatinine ratio has been found to be lowered in hypothyroidism and raised in hyperthyroidism.
Another rare cause of a decreased BUN is ornithine transcarbamylase deficiency, which is a genetic disorder inherited in an X-linked recessive pattern. OTC deficiency is also accompanied by hyperammonemia and high orotic acid levels.
BUN (urea-N) is mg/dL in the United States, Mexico, Italy, Austria, and Germany. Elsewhere, the concentration of urea is reported as mmol/L, generally depending on the lab.
BUN (urea-N) SI unit is mmol/L
BUN [mmol/L] = BUN [mg/dL] * 0.3571
To convert from mg/dL of blood urea nitrogen to mmol/L of urea, multiply by 0.357 (each molecule of urea having two nitrogens, each of molar mass 14g/mol) (BUN is the mass of nitrogen within urea/volume, not the mass of urea)
- Urea [mmol/L] = BUN [mg/dL of nitrogen] x 10 [dL/L] / 14x2 [mg N/mmol urea] (the mass of nitrogen within urea is used)
convert BUN to urea in mg/dL by using following formula:
- Urea [mg/dL]= BUN [mg/dL] * 2.14
(conversion factor derived by: MW of urea = 60, MW of urea nitrogen = 14x2 => 60/28 = 2.14)
factor = 1 for conversions in mmol (1 mole N2 = 2 moles N per mole of urea):
- BUN [mmol/L]= urea [mmol/L]
- Last page of Deepak A. Rao; Le, Tao; Bhushan, Vikas (2007). First Aid for the USMLE Step 1 2008 (First Aid for the Usmle Step 1). McGraw-Hill Medical. ISBN 0-07-149868-0.
- Normal Lab Results Archived December 16, 2014, at the Wayback Machine from Marshal University School of Medicine
- "Blood urea nitrogen (BUN) test - Mayo Clinic". www.mayoclinic.org. Retrieved 2019-05-13.
- Longo et al., Harrison's Principles of Internal Medicine, 18th ed., p.611