The BUN/Creatinine Ratio in Localizing Gastrointestinal Bleeding in Pediatric Patients

Felber, Sharon; Rosenthal, Philip; Henton, Donaby

doi:10.1097/00005176-198809000-00011

Cited by 21 publications

(9 citation statements)

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“…UGIB tends to have a larger volume of bleeding than LGIB. The BUN/Cr ratio has been shown to be a factor to differentiate UGIB from LGIB [6–9] particularly if the ratio is more than 30 [10]. The median of the BUN/Cr ratio in this study was 29.…”

Section: Discussionmentioning

confidence: 60%

How to Differentiate Sites of Gastrointestinal Bleeding in Patients with Hematochezia by Using Clinical Factors?

Sittichanbuncha

Senasu

Thongkrau

et al. 2013

Gastroenterology Research and Practice

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Hematochezia is one of common gastrointestinal complaint at the Emergency Department (ED). Causes may be due to upper (UGIB) or lower (LGIB) gastrointestinal tract bleeding. Here, clinical factors were studied to differentiate sites of bleeding in patients with hematochezia. All patients with an age of more than 18 years who were diagnosed with GIB at the ED, Ramathibodi Hospital, Thailand were enrolled. Patients who presented with hematochezia and received complete workups to identify causes of bleeding were studied and categorized as being in the UGIB or LGIB groups. There were 1,854 patients who presented with GIB at the ED. Of those, 76 patients presented with hematochezia; 30 patients were in the UGIB group, while 43 patients were in the LGIB group. Clinical variables between both groups were mostly comparable. Three clinical factors were significantly associated with UGIB causes in patients with hematochezia including systolic blood pressure, hematocrit level, and BUN/Cr ratio. The adjusted odds ratios for all three factors were 0.725 (per 5 mmHg increase), 0.751 (per 3% increase), and 1.11 (per unit increase). Physicians at the ED could use these clinical factors as a guide for further investigation in patients who presented with hematochezia.

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Section: Discussionmentioning

confidence: 60%

How to Differentiate Sites of Gastrointestinal Bleeding in Patients with Hematochezia by Using Clinical Factors?

Sittichanbuncha

Senasu

Thongkrau

et al. 2013

Gastroenterology Research and Practice

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“…This was an unexpected finding, because UCR cutoffs ranging from 30 to 36 are reported as markers for upper GIB in people. [7][8][9][10][11] These contradictory results may be a result of differences in inclusion criteria. Many studies in humans included only patients with overt GIB, 6,7,[29][30][31] whereas both overt and occult GI bleeders were enrolled in our study.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Different urea nitrogen/creatinine ratio (UCR) cutoffs to differentiate upper from lower GIB ranging from 30 to 36 have been reported in people. [7][8][9][10][11] Dogs with melena, hematemesis, or both had significantly higher UCR than did control dogs. 1 It is postulated that an increase in serum urea concentration in upper GIB is caused by increased hepatic ureagenesis after metabolism of blood proteins in the GI tract.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic evaluation of urea nitrogen/creatinine ratio in dogs with gastrointestinal bleeding

Stiller

Defarges

Brisson

et al. 2021

Veterinary Internal Medicne

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Background: Urea nitrogen/creatinine ratio (UCR) is a marker for upper gastrointestinal bleeding (GIB) in people.Objectives: To assess the usefulness of UCR to predict occult GIB and distinguish upper from lower GIB in dogs.Animals: Eighty-nine dogs with GIB and 65 clinically healthy dogs. Dogs were grouped according to 65 overt GIB and 24 occult GIB, and based on lesion localization (37 upper, 13 lower, and 8 both).Methods: Seventy-four dogs were included retrospectively and 15 dogs prospectively. Serum urea nitrogen and creatinine concentrations, UCR, hemoglobin concentration, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration were compared between groups. Logistic regression models were fitted to assess if variables could distinguish occult GIB from being healthy and upper from lower GIB.

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“…In previous studies, the BUN/Cr ratio has been reported as useful in localizing bleeding site in patients with GIB [ 9 , 10 , 11 , 12 ]. According to Felber et al [ 13 ], BUN/Cr ≥30 indicates UGIB, and <30 means UGIB or LGIB. In a study of children with GIB, the specificity and sensitivity of UGIB when BUN/Cr >30 were 98% and 68.8%, respectively [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Availability of Blood Urea Nitrogen/Creatinine Ratio in Gastrointestinal Bleeding with Melena in Children

Kim

Kang

Kim

2015

Pediatr Gastroenterol Hepatol Nutr

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PurposeThe aims of our study were to evaluate the blood urea nitrogen to creatinine ratio (BUN/Cr ratio) for distinguishing between an upper and lower gastrointestinal bleeding (GIB), and differentiating between the two most common causes of upper gastrointestinal bleeding (UGIB) presenting with melena in children.MethodsRetrospective data of patients with GIB presenting with melena were analyzed. The data from 60 cases were reviewed including demographics, laboratory findings, diagnostic modalities and results, treatments, and transfusions.ResultsAmong the 60 cases, UGIB and lower gastrointestinal bleeding (LGIB) were found in 35 cases (58.3%) and 14 cases (23.3%), respectively. The two common causes of UGIB were varices (37.1%), and peptic ulcer diseases (PUD) (31.4%). The BUN/Cr ratio of 30 or greater was higher in UGIB than LGIB (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 1.3-37.2). In UGIB, the BUN/Cr ratio of the varices group was higher than that of the PUD group (p=0.015). The OR for the BUN/Cr ratio appeared as 1.2 per unit increase in the varices group than the PUD group (95% CI, 1.03-1.3). There was no difference between the PUD group and Meckel's diverticulum group.ConclusionThe BUN/Cr ratio was not uneven in differentiating UGIB from LGIB of children with melena in our study. This suggests that BUN/Cr ratio should be interpreted carefully.

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The BUN/Creatinine Ratio in Localizing Gastrointestinal Bleeding in Pediatric Patients

Cited by 21 publications

References 0 publications

How to Differentiate Sites of Gastrointestinal Bleeding in Patients with Hematochezia by Using Clinical Factors?

How to Differentiate Sites of Gastrointestinal Bleeding in Patients with Hematochezia by Using Clinical Factors?

Diagnostic evaluation of urea nitrogen/creatinine ratio in dogs with gastrointestinal bleeding

Availability of Blood Urea Nitrogen/Creatinine Ratio in Gastrointestinal Bleeding with Melena in Children

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