The Decreased Serum Urea Nitrogen–Creatinine Ratio

Jurado, Rafael; Mattix, Holly

doi:10.1001/archinte.158.22.2509

Cited by 10 publications

(6 citation statements)

References 13 publications

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“…We found with increasing BUN/Cr ratio the risk of leukocytosis increases. BUN/Cr ratio has been previously identified as a marker of dehydration [23][24][25][26] . Also, associations between dehydration and acute phase reactants have been reported previously 19 .…”

Section: Discussionmentioning

confidence: 99%

Preoperative Leukocytosis in Colorectal Cancer Patients

Moghadamyeghaneh

Hanna

Carmichael

et al. 2015

Journal of the American College of Surgeons

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Section: Discussionmentioning

confidence: 99%

Preoperative Leukocytosis in Colorectal Cancer Patients

Moghadamyeghaneh

Hanna

Carmichael

et al. 2015

Journal of the American College of Surgeons

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“…Therefore, the proportion of muscle mass of an animal has been considered an important factor in the production rate and concentration of creatinine (Rodwell 2000). Plasma creatinine concentration also appears to increase when protein derived from muscle is used as an energy source at times of nutritional deprivation or after muscle damage (Nieminen and Timisjärvi 1983, Jurado and Mattix 1998). Changes in white‐tailed deer ( Odocoileus virginianus ) creatinine levels have been explained by increased Hct which was associated with dehydration or nutritional deprivation (DelGiudice et al .…”

Section: Discussionmentioning

confidence: 99%

Dietary and Seasonal Influences on Blood Chemistry and Hematology in Captive Harbor Seals

Trumble

Castellini

Mau

et al. 2006

Marine Mammal Science

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It has become increasingly important to understand the relationship between dietary intake and blood chemistry and hematological profiles in pinniped populations, especially where nutritional stress has been implicated in population declines. Blood chemistry and hematology reference ranges have been commonly reported for both free‐ranging and captive harbor seals, but seasonal and dietary fluctuations are limited to only a few studies. We quantified changes in plasma metabolites and hematology values in captive harbor seals on different diets over two years. Of 29 blood chemistry and hematology variables examined in captive harbor seals, ALT, AST, GGT, creatinine, and BUN:creatinine were influenced by diet. BUN, Na+, Cl−, Hct, and Hb were influenced by season. Diet did not affect hematology variables. While these data were collected on captive animals, we assume seasonal and dietary influences would be comparable in free‐ranging seals. According to this study, controlling for season during sampling becomes important when assessing blood chemistry values as an index of foraging status or health.

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“…Importantly, prerenal AKI is associated with a lower mortality than intrinsic AKI (2). Serum and urine diagnostic indices, including fractional excretion of sodium (FeNa), fractional excretion of urea (FeUrea), and urea creatinine (UC) ratio are commonly determined; however, these indices may be of limited utility in diagnosing intrinsic AKI (5, 7-9). Hence, the diagnostic workup and therapeutic management of patients with established AKI would greatly benefit from a clinical test that facilitates a differential diagnosis of intrinsic and prerenal AKI at an early time point and that helps in stratifying the patient at risk.…”

Section: Introductionmentioning

confidence: 99%

Urinary neutrophil gelatinase-associated lipocalin distinguishes pre-renal from intrinsic renal failure and predicts outcomes

Singer

Elger

Elitok

et al. 2011

Kidney International

185

138

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In established acute kidney injury (AKI), serum creatinine poorly differentiates prerenal and intrinsic AKI. A damage-associated nephron biomarker, neutrophil gelatinase-associated lipocalin (NGAL) could be a better discriminator. We tested the hypothesis that urinary NGAL distinguishes intrinsic and prerenal AKI, and tested its performance in the prediction of a composite outcome that included progression to a higher RIFLE (“risk, injury, failure, loss of function, end stage renal disease”) severity class, dialysis, or death. We measured urinary NGAL in 161 hospitalized patients with established AKI using a standardized clinical platform. We excluded 16 patients with postrenal obstruction or insufficient clinical information. Of the remaining 145 patients, 75 patients had intrinsic AKI, 32 patients had prerenal AKI, and 38 patients could not be classified. We found that urinary NGAL levels effectively discriminated intrinsic AKI from prerenal AKI (ROC 0.87, CI 0.81-0.94). An NGAL level >104 μg/L indicated intrinsic AKI (likelihood ratio 5.97), while an NGAL level <47 μg/L made intrinsic AKI unlikely (likelihood ratio 0.2). Patients experiencing the composite outcome had higher median urinary NGAL levels on inclusion (248.2 vs. 68.3 μg/L, p<0.001). In logistic regression analysis, NGAL independently predicted the composite outcome, when corrected for demographics, co-morbidities, creatinine, and RIFLE class. Hence, urinary NGAL is useful in classifying and stratifying patients with established AKI.

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The Decreased Serum Urea Nitrogen–Creatinine Ratio

Cited by 10 publications

References 13 publications

Preoperative Leukocytosis in Colorectal Cancer Patients

Preoperative Leukocytosis in Colorectal Cancer Patients

Dietary and Seasonal Influences on Blood Chemistry and Hematology in Captive Harbor Seals

Urinary neutrophil gelatinase-associated lipocalin distinguishes pre-renal from intrinsic renal failure and predicts outcomes

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