Ratio of blood urea nitrogen to serum creatinine at initiation of dialysis is associated with mortality: a multicenter prospective cohort study

Inaguma, Daijo; Koide, Shigehisa; Ito, Eri; Takahashi, Kazuo; Hayashi, Hiroki; Hasegawa, Midori

doi:10.1007/s10157-017-1458-x

Cited by 18 publications

(28 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We postulate that the urea-to-creatinine ratio might serve as a biomarker indicative of frailty. Elderly are more susceptible to dehydration and consequently, an increased urea-to-creatinine-level, due to physical barriers to self-hydration, a decrease in thirst sensation, use of diuretics and co-morbidity that increases water loss, including diabetes mellitus 21,25 . However, as we do not have measures of the (change in) body weight or alternative measures of hydration status, we cannot conclude to what extent dehydration caused the increased urea-to-creatinine-level in our population.…”

Section: Adj Hr (95% Ci) a P-valuementioning

confidence: 99%

“…Similar, Kirtane et al demonstrated that patients hospitalized with acute coronary syndrome and elevated serum urea levels were on average older, had a higher prevalence of co-morbidities and an increased short and long-term mortality rate 28 . In extension of these populations, an increased urea-to-creatinine ratio is also associated with worsening of renal function and all-cause mortality after hospitalization for acute heart failure 19,20 and long-term mortality among patients undergoing dialysis 21 . Thus, a higher urea-to-creatinine ratio might identify older, frail patients with an increased risk for long-term all-cause mortality after hospital discharge.…”

Section: Adj Hr (95% Ci) a P-valuementioning

confidence: 99%

“…Consequently, an increased urea-to-creatinine ratio may identify patients with transient AKI that are not at risk for long-term mortality after sepsis and potentially also among patients with less severe infections. In other patients, such as patients with heart failure or undergoing dialysis, an increased urea-to-creatinine ratio is already associated with all-cause long-term mortality 19 – 21 . The association between the urea-to-creatinine ratio and the course of both types of AKI with long-term mortality with AKI in patients with infection is not yet known.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A high urea-to-creatinine ratio predicts long-term mortality independent of acute kidney injury among patients hospitalized with an infection

Slikke

Star

Jager

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Acute kidney injury (AKI) occurs frequently in patients with sepsis. Persistent AKI is, in contrast to transient AKI, associated with reduced long-term survival after sepsis, while the effect of AKI on survival after non-septic infections remains unknown. As prerenal azotaemia is a common cause of transient AKI that might be identified by an increased urea-to-creatinine ratio, we hypothesized that the urea-to-creatinine ratio may predict the course of AKI with relevance to long-term mortality risk. We studied the association between the urea-to-creatinine ratio, AKI and long-term mortality among 665 patients presented with an infection to the ED with known pre-existent renal function. Long-term survival was reduced in patients with persistent AKI. The urea-to-creatinine ratio was not associated with the incidence of either transient or non-recovered AKI. In contrast, stratification according to the urea-to-creatinine-ratio identifies a group of patients with a similar long-term mortality risk as patients with persistent AKI. Non-recovered AKI is strongly associated with all-cause long-term mortality after hospitalization for an infection. The urea-to-creatinine ratio should not be employed to predict prerenal azotaemia, but identifies a group of patients that is at increased risk for long-term mortality after infections, independent of AKI and sepsis.

show abstract

Section: Adj Hr (95% Ci) a P-valuementioning

confidence: 99%

Section: Adj Hr (95% Ci) a P-valuementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A high urea-to-creatinine ratio predicts long-term mortality independent of acute kidney injury among patients hospitalized with an infection

Slikke

Star

Jager

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Most studies that explored the relationship between renal-related biomarkers and mortality 7 – 15 had been conducted in special populations, such as persons with diabetes 2 , persons with CKD 7 , 9 , persons undergoing percutaneous intervention 8 , persons with hypertension 12 , or persons participating in comprehensive health screening programs 15 . By contrast, studies that focused on general populations are few 10 , 11 , 13 , 14 , 16 , 17 .…”

Section: Introductionmentioning

confidence: 99%

“…The results of investigations on renal-related biomarkers with mortality are inconsistent. Previous studies reported that high levels of blood urea nitrogen (BUN) are associated with an increase in all-cause mortality 7 – 9 . Low levels of eGFR reportedly have a positive 10 , 12 or a J-shaped association 11 or no association at all 9 , 13 with all-cause or CVD mortality.…”

Section: Introductionmentioning

confidence: 99%

Renal markers and risks of all cause and cardiovascular mortality from the Taichung community based cohort study

Lin

Chen

et al. 2021

Sci Rep

View full text Add to dashboard Cite

This study aimed to explore the associations between renal-related and arterial stiffness biomarkers with all-cause and expanded cardiovascular disease (CVD) mortality in a general Taiwanese population. This prospective community-based cohort study included 4883 subjects aged ≥ 20 years who were followed up until December 31, 2016. Renal-related biomarkers consisted of blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio (UACR). Arterial stiffness biomarker consisted of brachial-ankle pulse wave velocity (baPWV). The death status of the subjects was ascertained by matching information from death records with the identification number and date of birth of the subjects. Cox proportional hazard models with restricted cubic splines estimated the hazard ratios and 95% confidence intervals for all-cause mortality and expanded CVD mortality. During a mean 8.3 years of follow up, 456 deaths were recorded, 146 of which were due to expanded CVD mortality. The multivariable-adjusted hazard ratios of all-cause mortality was 1.53 (95% CI 1.21–1.94) for BUN (≥ 20 mg/dL vs. < 20 mg/dL), 1.57 (1.15–2.14) for eGFR (< 90 mL/min/1.73 m2 vs. ≥ 90 mL/min/1.73 m2), 1.55 (1.25–1.92) for UACR (≥ 30 mg/g vs. < 30 mg/g), and 1.75 (1.14–2.67) for baPWV (≥ 1400 cm/s vs. < 1400 cm/s). The expanded CVD mortality was 1.89 (95% CI 1.30–2.73) for BUN (≥ 20 mg/dL vs. < 20 mg/dL), 2.28 (1.13–4.57) for eGFR (< 90 mL/min/1.73 m2 vs. ≥ 90 mL/min/1.73 m2), 2.13 (1.52–2.99) for UACR (≥ 25 mg/g vs. < 25 mg/g), and 15.73 (2.14–115.61) for baPWV (≥ 1400 cm/s vs. < 1400 cm/s). High levels of BUN, UACR, and baPWV and low levels of eGFR showed high risks with all-cause and expanded CVD mortality. Our study provides insights into screening tests to target populations at high risk of premature death due to CVD.

show abstract

Plasma urea:creatinine ratio as a biomarker of gastrointestinal bleeding in dogs with anaemia

Safrany,

Holmes,

Adamantos

et al. 2023

Veterinary Medicine & Sci

View full text Add to dashboard Cite

BackgroundGastrointestinal bleeding is a cause of anaemia in dogs. A reliable, non‐invasive biomarker to differentiate gastrointestinal bleeding from other causes of anaemia would be advantageous to direct clinical decisions in anaemic patients. Plasma urea:creatinine ratio is an accepted biomarker of upper gastrointestinal bleeding in human medicine.ObjectivesThe objective of this study was to evaluate plasma urea:creatinine ratio as a biomarker of gastrointestinal bleeding in a population of dogs with anaemia.MethodsThis was a prospective cross‐sectional study of dogs with anaemia presenting to referral centres for the investigation of anaemia. Cases were categorised as having overt gastrointestinal bleeding (melena on presentation), occult gastrointestinal bleeding (historical and diagnostic findings consistent with gastrointestinal bleeding without melena at presentation) or anaemia of other cause (confident diagnosis other than gastrointestinal bleeding reached, normal diagnostic imaging of gastrointestinal tract). Urea:creatinine ratio at presentation was calculated by dividing urea (mg/dL) by creatinine (mg/dL).ResultsNinety‐five dogs were included. Plasma urea:creatinine ratio was not significantly different between dogs with overt or occult gastrointestinal bleeding or those with anaemia of other cause (median urea:creatinine ratio 25.8, 20.7 and 22.5, respectively). No significant difference in urea:creatinine ratio was found between dogs with upper and lower gastrointestinal bleeding (median urea:creatinine ratio 19.4 and 24.6, respectively).ConclusionsPlasma urea:creatinine ratio was not helpful in differentiating between dogs with anaemia resulting from gastrointestinal bleeding (overt or occult) and those with other causes of anaemia.

show abstract

Ratio of blood urea nitrogen to serum creatinine at initiation of dialysis is associated with mortality: a multicenter prospective cohort study

Abstract: The BUN/Cr ratio at the time of initiation of dialysis was associated with all-cause mortality.

Cited by 18 publications

References 28 publications

A high urea-to-creatinine ratio predicts long-term mortality independent of acute kidney injury among patients hospitalized with an infection

A high urea-to-creatinine ratio predicts long-term mortality independent of acute kidney injury among patients hospitalized with an infection

Renal markers and risks of all cause and cardiovascular mortality from the Taichung community based cohort study

Plasma urea:creatinine ratio as a biomarker of gastrointestinal bleeding in dogs with anaemia

Contact Info

Product

Resources

About