BUN: Creatinine Ratio - Definition of the Normal Range in Children

Gordon, Sharon; Sethna, Christine B.; Frank, Rachel; Vento, Suzanne; Goilav, Béatrice; Tau, Michael; Trachtman, Howard

doi:10.4081/nr.2010.e11

Cited by 6 publications

(7 citation statements)

References 10 publications

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“…While the BUN/creatinine ratio is typically preserved during CKD progression and intrinsic AKI, an increasing BUN/creatinine ratio indicates that the plasma urea is increased relative to creatinine and is usually seen in the setting of high protein dietary intake, catabolic states, gastrointestinal bleeds, or decreased renal perfusion (35). A similar correlation between the BUN/creatinine ratio and eGFR was noted in a survey of children seen as outpatients in a Pediatric Nephrology clinic; they noted a higher BUN/creatinine ratio in females where ins our stone cohort males had a higher BUN/creatinine ratio (36). Other markers for dietary protein intake including urine urea nitrogen (UUN) and urine sulfate significantly correlated with eGFR supporting a potential link between dietary protein intake and hyperfiltration.…”

Section: Discussionsupporting

confidence: 84%

Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex

et al. 2019

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Background: Urinary stones are affecting more children, and pediatric stone formers have unique pathophysiology compared to adults. While adult stone formers are most frequently male, children have an age dependent sex prevalence. Under 10 years, a majority of stone formers are boys; adolescent stone formers are mostly female. Previous adult studies have shown that stone composition is influenced by the sex and age of the stone former. Thus, we hypothesize that female and male stone forming children will also have sex and age specific stone phenotypes. Methods: Retrospective chart review of a large pediatric center's stone forming children 6/1/2009 to 6/1/2016. Patients were identified by ICD 9 codes: N20, N20.1, and N20.9. Charts were reviewed for radiographic evidence of stones or documented visualized stone passage. Results: One hundred and thirty six subjects: 54 males and 82 females. Females were older, median age 14 years [interquartile range (IQR): 11, 15] vs. males' median age 12 years (IQR: 11, 14) ( p < 0.01). Females had lower height z -scores, median 0.2 (IQR: −0.8, 0.8) vs. males' median 0.8 (IQR: −0.2, 1.8) ( p < 0.01). Presenting symptoms were similar except flank pain affecting 39% of females vs. 22% of males ( p = 0.04). Leukocyte esterase was positive in more females than males (33 vs. 4%) ( p < 0.001). Males had a higher BUN/Cr ratio, mean ± standard deviation of 19.8 ± 6.3 vs. 16.6 ± 6.5 in females ( p = 0.01). Glomerular hyperfiltration was present in 9% of patients while 35% of patients had estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m 2 . Treatment strategies and clinical course were similar except females were told to increase dietary citrate more frequently than males (21 vs. 4%) ( p < 0.01). Conclusion: We have provided a novel analysis and demonstrated that low height z -score and pyuria are more common in female stone formers. We have also shown that 9% of pediatric stone formers have labs consistent with hyperfiltration. Whether high protein intake and/or chronic dehydration are associated with hyperfiltration and long-term renal function in children with kidney stones will be an area for future research.

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Section: Discussionsupporting

confidence: 84%

Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex

et al. 2019

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“…These findings imply that sex differences in protein turnover do not occur until later in life. Indeed, high BUN/creatinine ratio was shown in subjects who are over the age of 65 and without previously detected medical disorders,27 but not in children (mean age 12.4 years) 28. These findings support our hypothesis regarding sex difference in age-related change in BUN/creatinine ratio.…”

Section: Discussionsupporting

confidence: 84%

Blood urea nitrogen-to-creatinine ratio in the general population and in patients with acute heart failure

Matsue¹,

Meer²,

Damman³

et al. 2016

Heart

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“…15 Likewise, another small single center retrospective review showed that the mean BUN value for children less than 2 years of age was 20.1 ±1.91 mg/dl and 2-5 years of age was 16.5±14.0 mg/dl. 5 Nevertheless, the average BUN in ours study was found to be quite high. In adults, a BCR of 20:1 is generally considered a marker for differentiation of pre-renal AKI from other causes of renal injury.…”

Section: Discussioncontrasting

confidence: 65%

“…Whether or not BCR can be a sensitive tool in distinguishing patterns of renal injury in children is still a matter of controversy. 5 While presence of dehydration is a poor prognostic factor in AGE, clinical dehydration assessment can have subjective variation. BCR being a quantitative variable, it can be useful if dehydration can be correlated with BCR values.…”

Section: Introductionmentioning

confidence: 99%

Profile of Acute Gastroenteritis in Children Under Five Years of Age, and Their Association With Blood Urea Nitrogen-to-Creatinine Ratio

Ahmad¹,

Kapil²,

Subedi³

2022

JCMC

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Background: Acute gastroenteritis (AGE) is a major cause of childhood morbidity and mortality, especially in developing countries. This study aimed to explore the clinical and laboratory profile in under five children with AGE. It furthermore aimed to study the association of socio-demographic and clinical parameters with blood urea nitrogen and serum creatinine ratio (BCR). Methods: This was a cross-sectional study carried among 62 under-five children in the Pediatric Department, Nepalgunj Medical College and Teaching Hospital. Data was entered in excel and analyzed in statistical package for social sciences. Demographic and clinical data obtained from informants was presented as frequency and percentage. BCR was calculated based on baseline serum urea and creatinine values. Chi square test and logistic regression were used to study the association of clinical and demographic profiles with BCR. Adjusted odds ratio was calculated at 95% confidence interval. Results: The mean age of participants was 26 months. Most of the children belonged to low socio-economic status (44, 70.97%). Dehydration was the commonest clinical association (51,82.25%) followed by fever (31,50%) and abdominal pain (31,50%). Multivariate logistic regression showed that children with dehydration had greater odds (Adjusted odds ratio (AOR)=5.82) of having BCR greater than 20:1 as opposed to those without dehydration. Conclusions: AGE was commonly seen in children with low socio-economic status. Dehydration, fever and abdominal pain were common clinical associations. High BCR (20:1) was positively associated with presence of dehydration in children presenting with acute gastroenteritis.

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BUN: Creatinine Ratio - Definition of the Normal Range in Children

Cited by 6 publications

References 10 publications

Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex

Comparison of Risk Factors for Pediatric Kidney Stone Formation: The Effects of Sex

Blood urea nitrogen-to-creatinine ratio in the general population and in patients with acute heart failure

Profile of Acute Gastroenteritis in Children Under Five Years of Age, and Their Association With Blood Urea Nitrogen-to-Creatinine Ratio

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