What Does It Mean When Bun/Creatinine Ratio Is Low?

What Does It Mean When Bun/Creatinine Ratio Is Low

Should I be concerned about a low BUN creatinine ratio?

Interpreting Low BUN-to-Creatinine Ratios – A low BUN-to-creatinine ratio can have several causes. For example, it may be associated with low protein intake, malnutrition, liver disease, or conditions affecting muscle mass. Low ratios can also be seen in individuals with certain metabolic disorders.

Is low bun creatinine bad?

What does it mean if your BUN/Creatinine Ratio result is too low? A decreased ratio may be observed with liver disease and poor diet. Temporary levels that are high or low may not be a cause for concern and should be retested to confirm. – Liver disease can cause a lower BUN level.

Is low BUN level serious?

Interpreting test results – The test report should include a line for BUN that shows the level found in your sample as well as the laboratory’s reference range. BUN is typically reported in milligrams per deciliter of blood (mg/dL). Working with your doctor is the best way to understand the significance of your BUN test.

  • The American Board of Internal Medicine lists a typical reference range for BUN as eight to 20 mg/dL.
  • However, this range is not universal.
  • Labs can use different methods to measure BUN or report BUN in different units, and what constitutes a normal result can vary from lab to lab.
  • If you had a panel test, you should see separate test results for any other measurements taken along with BUN.

Each test component will have the listed reference range for the laboratory that conducted your test. Your doctor can discuss your BUN levels and how they relate to your overall health, symptoms, and other test measurements. This is important because BUN levels alone are not a consistent predictor of kidney function.

Elevated BUN can occur with kidney problems, but it can also happen from eating lots of protein, taking certain medications, or other issues like dehydration or burns. BUN levels often rise with aging as well. Independently, blood urea nitrogen may not reflect kidney function. For this reason, it is often interpreted in the context of other measurements, such as creatinine, a breakdown product of the muscle filtered by the kidneys.

In some cases, the doctor may look at the ratio of BUN to creatinine to help determine the underlying cause of the altered kidney function. Abnormally low BUN levels can signify malnutrition, lack of protein in the diet, and liver disease. Therefore, other tests included in a panel test, like the CMP, may provide helpful information for understanding the significance of low BUN.

Was my BUN level normal or abnormal? Were any other measurements taken along with BUN? What do the test results mean for my kidney function? If my test was abnormal, what is the most likely explanation for that result? Should I repeat the BUN test at any point or have any other follow-up tests?

BMP Blood Test (Basic Metabolic Panel) CMP Blood Test (Comprehensive Metabolic Panel) Creatinine Blood Test eGFR Test (Estimated Glomerular Filtration Rate) Renal Panel Test

What happens when creatinine ratio is low?

Low values –

Low blood creatinine levels can mean lower muscle mass caused by a disease, such as muscular dystrophy, or by aging. Low levels can also mean some types of severe liver disease or a diet very low in protein. Pregnancy can also cause low levels. Low creatinine clearance levels can mean you have chronic kidney disease or serious kidney damage. Kidney damage can be from conditions such as a life-threatening infection, shock, cancer, low blood flow to the kidneys, or urinary tract blockage. Other conditions, such as heart failure and dehydration, can also cause low clearance levels. Low BUN-to-creatinine ratios may be linked with a diet low in protein, a severe muscle injury called rhabdomyolysis, pregnancy, cirrhosis, or syndrome of inappropriate antidiuretic hormone secretion (SIADH). SIADH sometimes occurs with lung disease, cancer, diseases of the central nervous system, or the use of certain medicines.

Does low BUN mean kidney damage?

Jump to Sections –

  1. What Does BUN Mean in a Blood Test?
  2. BUN Normal Range
  3. What Does High BUN Mean?
  4. What Does Low BUN Mean?

BUN levels are a measurement of how much urea has been processed by the kidneys. Urea is a waste product that is excreted in urine. A patient’s high BUN levels may indicate that their kidneys aren’t functioning properly, while lower BUN levels indicate overhydration, liver disease, or malnutrition.

What causes low creatinine?

The two sides of creatinine: both as bad as each other? Acute and chronic kidney diseases are major public health problems, and even relatively small rises in serum creatinine have been found to be associated with an increased risk of morbidity and mortality (-). In contrast, the relevance of serum creatinine levels below the normal range is appreciated far less in clinical practice. A recent paper published in Critical Care Medicine alluded to the fact that a low serum creatinine is an important risk factor for poor outcome (). Using the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation database, Udy et al, retrospectively analyzed the data of >1 million adult patients admitted to ICU between 2000–2013 and evaluated the association between peak serum creatinine concentration in the first 24 hours of ICU admission and hospital mortality (). Patients on chronic dialysis, re-admissions, and renal transplant recipients were excluded. The key findings were:

A peak serum creatinine concentration <60 µmol/L in the first 24 hours after ICU admission was independently associated with an increased risk of mortality; In patients with a serum creatinine 180 µmol/L.

These findings were consistent across medical, surgical, trauma and infection-related admission types and independent of gender, age, and admission year. Weight and height data to calculate the body mass index (BMI) were available for 9% of patients, and analysis of this cohort showed that the relationship between low serum creatinine and hospital mortality was consistent across all BMI categories. Although neither the aetiology of low creatinine levels nor the causes of death were available, these results may have very important repercussions for clinical practice. Firstly, the paper serves as a reminder that serum creatinine is more than a marker of renal function. Creatinine is a metabolite of creatine and as such a by-product of muscle metabolism. Creatine is initially synthesized from the amino acids glycine and arginine in liver and kidneys and then transported to the skeletal muscle cells. A proportion of creatine also stems from dietary meat intake. Following conversion to phosphocreatine, it serves as a rapidly mobilizable reserve of high-energy phosphates in muscle. The total amount of creatinine generated from creatine is determined by muscle function, meat intake and de novo generation of creatine. In health, creatinine is produced at a constant rate, but rapid, substantial and sustained falls in production have been demonstrated during critical illness. Therefore, the concentration of creatinine measured in the serum represents the balance between creatinine production and creatinine clearance. Because creatinine is freely filtered across the glomerulus and is neither reabsorbed nor metabolized by the kidney (although tubular secretion does occur), it serves as a marker of renal function in clinical practice. However, serum creatinine has important limitations: it can take 24–36 hours to rise after a definite renal insult, it may overestimate renal function as a result of secretion in the proximal tubule and it can increase following administration of medications that inhibit tubular secretion despite no change in renal function. In addition, creatinine is distributed in total body water and measured as a concentration and may, therefore, be affected by variations in volume status. The causes of a low serum creatinine concentration are generally well known and include reduced muscle bulk, liver disease, significant fluid overload and poor nutritional status but also augmented renal clearance as seen in pregnancy. Although previous studies have described the association of increased mortality with lower creatinine levels in patients on chronic dialysis, in those commencing renal support in the ICU and in older patients (-), the implications of a low serum creatinine in critically ill patients are less well known. The study by Udy et al, with data of >1 million patients is undoubtedly the largest in the literature. Cartin-Ceba et al, previously performed a retrospective analysis of 11,291 critically ill patients admitted to three ICUs over a 47-month period and like Udy et al, showed that both a high and low serum creatinine were risk factors for poor outcome (). A low baseline serum creatinine was independently associated with increased hospital mortality in a concentration-dependent fashion. Adjusted stay in ICU was also longer in this cohort. The question is what mechanisms could underlie these observations. The studies by Udy et al, and Cartin-Ceba et al, do not provide any definitive mechanistic insights (,). Without detailed data about the underlying causes, it is certainly possible that a low serum creatinine was simply an indicator of underlying chronic liver disease, reduced muscle mass, and poor nutritional state. Both studies focused on creatinine concentrations in the first 24 hours of ICU admission. One potential explanation given by the authors is that the results may have been confounded by chronic fluid overload or excessive fluid administration pre-ICU. It is likely that the relationship between low serum creatinine levels and mortality is more complex than assumed at first glance. For instance, serum creatinine can overestimate renal function, and a proportion of patients with a serum creatinine level below the normal range may have had significantly impaired renal function. Udy et al, also showed that the adjusted hospital mortality of patients with a serum creatinine <50 µmol/L in the first 24 hours of admission increased with rising admission albumin levels and was highest in those with a plasma albumin ≥45 g/L (). The authors argue that a low serum creatinine in the setting of adequate albumin levels may imply marked physical deconditioning or muscle wasting (,). Although this is possible, it remains unproven. Using a large database, the authors obviously were unable to provide data on detailed muscle function. Instead, they analyzed the impact of serum creatinine in different BMI groups and showed that the association between low serum creatinine and mortality was independent of BMI. However, BMI is a poor marker of muscle mass (). What are the practical implications of these results? With data of >1 million ICU patients from an ethnically diverse population, the study by Udy et al, has external validity. Clearly, further studies are needed, especially to provide mechanistic insights that could lead to potential therapeutic interventions. In the meantime, the presence of a low baseline serum creatinine level should alert clinicians to the high-risk potential of individual patients. Interestingly, the APACHE II score includes a low creatinine value as a risk factor and assigns two points to the severity score if the most extreme serum creatinine level during the first 24 hours is <0.6 mg/dL (53 µmol/L). However, other risk prediction scores like the Simplified Acute Physiology Score II and Sequential Organ Failure Assessment (SOFA) score do not take into account low creatinine levels. We already know that high creatinine levels are associated with poor outcomes, and now we know that low levels may be just as bad whatever the exact cause. Provenance: This is an invited Commentary commissioned by the Section Editor Zhongheng Zhang (Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Jinhua, China). Conflicts of Interest: The authors have no conflicts of interest to declare.1. Hoste EA, Bagshaw SM, Bellomo R, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 2015; 41 :1411-23.10.1007/s00134-015-3934-7 2. Mehta RL, Cerdá J, Burdmann EA, et al. International Society of Nephrology's 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet 2015; 385 :2616-43.10.1016/S0140-6736(15)60126-X 3. Lewington AJ, Cerdá J, Mehta RL. Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int 2013; 84 :457-67.10.1038/ki.2013.153 4. Lassnigg A, Schmidlin D, Mouhieddine M, et al. Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol 2004; 15 :1597-605.10.1097/01.ASN.0000130340.93930.DD 5. Udy AA, Scheinkestel C, Pilcher D, et al. The Association Between Low Admission Peak Plasma Creatinine Concentration and In-Hospital Mortality in Patients Admitted to Intensive Care in Australia and New Zealand. Crit Care Med 2016; 44 :73-82.10.1097/CCM.0000000000001348 6. Kakiya R, Shoji T, Tsujimoto Y, et al. Body fat mass and lean mass as predictors of survival in hemodialysis patients. Kidney Int 2006; 70 :549-56.10.1038/sj.ki.5000331 7. Smith GL, Shlipak MG, Havranek EP, et al. Serum urea nitrogen, creatinine, and estimators of renal function: mortality in older patients with cardiovascular disease. Arch Intern Med 2006; 166 :1134-42.10.1001/archinte.166.10.1134 8. Barton IK, Hilton PJ, Taub NA, et al. Acute renal failure treated by haemofiltration: factors affecting outcome. Q J Med 1993; 86 :81-90.9. Forni LG, Wright DA, Hilton PJ, et al. Prognostic stratification in acute renal failure. Arch Intern Med 1996;156:1023, 1027.10. Cartin-Ceba R, Afessa B, Gajic O. Low baseline serum creatinine concentration predicts mortality in critically ill patients independent of body mass index. Crit Care Med 2007; 35 :2420-3.10.1097/01.CCM.0000281856.78526.F4 11. Thongprayoon C, Cheungpasitporn W, Kashani K. Serum creatinine level, a surrogate of muscle mass, predicts mortality in critically ill patients. J Thorac Dis 2016; 8 :E305-11.10.21037/jtd.2016.03.62 : The two sides of creatinine: both as bad as each other?

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Can dehydration cause low BUN creatinine?

Why It Is Done – These tests are done:

To see if your kidneys are working normally. To find out if your kidney disease is changing. To see how well the kidneys work in people who take medicines that can cause kidney damage. To check for severe dehydration, Dehydration generally causes BUN levels to rise more than creatinine levels. This causes a high BUN-to-creatinine ratio. Kidney disease or blocked urine flow from your kidney causes both BUN and creatinine levels to rise.

Does low BUN mean liver damage?

Symptoms of liver and kidney disease – According to the Centers for Disease Control and Prevention (CDC), an estimated 15 percent of adults in the United States have long-term kidney disease, known as chronic kidney disease, Many people are unaware that they have the condition. Symptoms of kidney disease include:

frequent urination, especially at nightchange in urine volumedecreased need to urinatea burning sensation during urinationbrown or red urine that appears foamypain, especially in the area near the kidneys (flank region)muscle crampsnumbness in the hands and feetinterrupted sleep tiredness and a lack of concentration or alertnessitchinesspoor appetitenauseaswelling or puffiness, especially around the face, wrists, ankles, abdomen, and thighs high blood pressure

Symptoms of liver disease include:

dark colored urinepale-colored stoolskin and whites of the eyes that appear yellowbruising easilyloss of appetitenausea or vomiting diarrhea weight loss or gainongoing tiredness or weaknessabdominal pain and swellingswelling in the legs and anklesitchiness

Preparing for a BUN test is relatively straightforward. Those having a BUN test should eat and drink as usual before the test. This helps ensure that results accurately reflect levels as they usually are. Tell the doctor about any medications or supplements taken before or on the day of the test.

  1. To perform the BUN test, a healthcare professional draws blood from a vein.
  2. They will often use a vein in front of the elbow or the back of the hand.
  3. Laboratory technicians will then examine the blood sample and send the results to the individual’s doctor.
  4. After the test, most people return to their usual routine.
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However, some people may also feel faint, hungry, or dehydrated. If the area around the draw site becomes painful, inflamed, or starts to discharge pus or excess blood, the person should seek medical attention. A BUN test that demonstrates a rise or fall in blood urea nitrogen levels might indicate a wide range of health problems.

Adults up to 60 years of age: 6-20 mg/dLAdults over 60 years of age: 8-23 mg/dL

However, these ranges will likely vary from lab to lab. If you are significantly outside the normal range at the lab your blood is sent to, it could be due to underlying kidney or liver disease. The following factors can lead to elevated BUN levels:

kidney damage, failure, or disease dehydration shockurinary tract blockages or diseasegastrointestinal bleeding heart attack heart failure eating too much proteinbreaking down too much proteinintense stress poor circulation obesity high cholesterol

Low BUN levels, which are not common, can result from:

liver failureover-hydrationnot consuming enough protein in the diet due to poor nutrition or a very low-protein diet

Typically, BUN levels increase with age. Changes in BUN levels also occur and during pregnancy. The ideal range of BUN values might vary based on the person’s age and the reference range that the laboratory uses. People should speak to their doctor about what their results mean.

Certain over-the-counter (OTC) painkillers, in particular, non-steroidal anti-inflammatory drugs (NSAIDs), can all adversely affect the kidneys. This class of drugs includes ibuprofen, naproxen, and aspirin, Natural diuretics, such as caffeine, and prescription diuretics can also affect the kidneys. Antibiotics can also impact BUN levels.

Many prescription drugs can affect the kidneys, some less frequently than others, resulting in abnormal BUN levels, including:

amphotericin Bcarbamazepinecelecoxibcephalexinfurosemidemethotrexate penicillin rifampinspironolactonehydrochlorothiazidefurosemidegentamicintetracyclinevancomycinsulfonamide antibiotics

According to the National Kidney Foundation, herbal supplements can also adversely affect the kidneys of people with kidney disease. Generally, the U.S. Food and Drug Administration (FDA) does not regulate natural health products. This means that the effective dosage, source, and even the precise mixture of the supplement are uncertain.

This lack of regulation also means herbal supplements may contain compounds that damage the kidneys, such as heavy metals or aristolochic acid. People with kidney or liver disease should also limit or monitor phosphorous and potassium intake. Share on Pinterest BUN tests can provide a picture of kidney health but not diagnose a disease.

BUN testing alone is not enough to diagnose any condition. It may merely highlight the need for further, more specific testing. If BUN results come back higher or lower than usual, a healthcare professional will usually follow up with other tests. A serum creatinine test combined with the BUN level can help highlight particular conditions.

  • A doctor may also carry out testing to measure the blood levels of specific electrolytes, such as potassium, sodium, and calcium, as well as ordering urine tests.
  • Commonly, a serum chemistry panel is ordered, which typically measures the levels of BUN, creatinine, and electrolytes.
  • In some instances, doctors may also follow up abnormal BUN results by evaluating the BUN-to-creatinine ratio in the bloodstream.

Creatinine is a waste product that occurs after the muscles break down creatine. Creatine is a product of amino acid metabolism made after protein breakdown, and it is necessary for the body, helping to produce energy and move the muscles. The ratio of BUN to creatinine is usually between 10:1 and 20:1,

The course of treatment for each person with abnormal BUN levels varies depending on the cause and severity. Less serious health issues that lead to abnormal BUN levels might require less intense therapy and long-term monitoring. People with more severe conditions, such as end-stage kidney disease, often need intensive and on-going treatment, such as dialysis.

In the case of abnormal BUN levels caused by eating too much protein, people can limit the amount of protein-rich foods, such as meat, fish, beans, and dairy, and increase the amount of fruit and vegetables they consume. Staying well-hydrated also helps prevent the buildup of BUN.

How is low BUN and creatinine treated?

How to increase creatinine levels. Gentle exercise to increase muscle mass, or increasing creatine intake in the diet may help, particularly for those on a vegetarian diet who may not be eating enough protein. For people who do high-intensity exercise, creatine as a dietary supplement is generally considered safe.

What level of creatinine is alarming?

What Are High and Low Creatinine Levels? – What Does It Mean When Bun/Creatinine Ratio Is Low High creatinine levels can mean kidney damage or dehydration. A high creatinine level is typically anything over 1.3 (depending on age, race, gender, and body size). Certain conditions may cause a person to have higher than normal levels of creatinine.

People with only one kidney may have a normal creatinine level of about 1.8 or 1.9. Creatinine levels of 2.0 or more in infants and 5.0 or more in adults may indicate severe kidney damage. People who are dehydrated may have elevated creatinine levels.

Low creatinine levels are often seen in patients with low muscle mass and are not usually considered a serious medical problem.

Does low creatinine mean not enough protein?

Low Blood Creatinine – Low blood creatinine levels are not always a concern. They can just indicate a diet low in protein, Your doctor will interpret your results, taking into account your medical history, symptoms, and other test results.

What level of creatinine indicates kidney failure?

What are considered high and low creatinine levels? –

A person with only one kidney may have a normal level of about 1.8 or 1.9. High creatinine levels that reach 2.0 or more in babies and 5.0 or more in adults may indicate severe kidney impairment. The need for a dialysis machine to remove wastes from the blood is based upon several considerations including the BUN, creatinine level, potassium level, and how much fluid the patient is retaining. Low creatinine levels indicate malnutrition, severe weight loss, long term illness, and low muscle mass such as in the elderly and infant

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What Does It Mean When Bun/Creatinine Ratio Is Low

What level of BUN requires dialysis?

Abstract – The indications for dialysis in patients with acute kidney injury (AKI), as well as the dose and timing of initiation, remain uncertain. Recent data have suggested that early initiation of renal replacement therapy (RRT) may be associated with decreased mortality but not with the recovery of kidney function.

Do kidney stones cause low BUN?

A blockage in the urinary tract (such as a kidney stone) can cause a high BUN-to-creatinine ratio. A very high BUN-to-creatinine ratio may be caused by bleeding in the digestive tract or respiratory tract. A low BUN value may be caused by a diet very low in protein, malnutrition, or severe liver damage.

Does low BUN mean low iron?

Complete Blood Count (CBC) explanation: –

White Blood Count (WBC) – High WBC can be a sign of infection or leukemia. Low white counts can be a sign of bone marrow disease or an enlarged spleen. Red Blood Count (RBC) – Both high and low values can point to abnormal conditions and require further evaluations. High levels can mean pulmonary (lung) problems. Low levels can indicate anemia. Hemoglobin (Hgb) and Hematocrit (Hct) – Low Hgb or Hct suggests anemia. High Hgb can occur due to lung disease, living at high altitudes, or excessive bone marrow production of blood cells. Mean Corpuscular Volume (MCV) – is a calculation of the amount of oxygen-carrying hemoglobin inside your RBCs. High levels may not be significant. Low levels may mean you do not have enough oxygen-carrying cells to supply your body with oxygen. Red Cell Distribution Width (RDW) – is a calculation of the variation in the size of your RBCs. This information can be used in evaluating the severity of some anemias. Platelet Count (PLT) – helps prevent bleeding. High values can occur with bleeding, cigarette smoking or excess production by the bone marrow. Low values can occur from acute blood loss, infections and leukemia.

There are five different types of white blood cells, each with its own function in protecting us from infection. The differential classifies a person’s white blood cells into each type: Neutrophils, monocytes, eosinophils and basophils. Elevated levels may mean you have or have recently had an infection. Low levels may indicate anemia of the Hgb and Hct are low. : Womens Clinic

What organ does BUN affect?

Is there anything else I need to know about a BUN test? – A BUN test is only one type of measurement of kidney function. If your provider thinks you may have kidney disease, you may need other tests. These may include tests to measure:

  • Creatinine, which is another waste product that your kidneys remove from your body
  • GFR (Glomerular Filtration Rate), which estimates how well your kidneys are filtering blood

Can exercise increase BUN levels?

Abstract – Examination of 19 serum biochemical and hematologic parameters in a group of white male runners, ranging in age from 23 to 47 years, just prior to and immediately after a 13-mile “mini-marathon,” demonstrated a significant increase, by paired Student t-test, in mean values of: K+, BUN, creatinine, CK, LDH, AST (SGOT), alkaline phosphatase, bilirubin, uric acid and leukocyte counts.

  • Prevailing environmental conditions were such as to produce no significant hemoconcentration.
  • Using this group’s statistics and this hospital laboratory’s upper limits of normal, the percentage of values above two SDs are, for the resting state: K+ 7%, BUN 7%, creatinine 0%, CK 21%, LDH 21%, AST 0%, alkaline phosphatase 0%, bilirubin 7%, uric acid 7%, and leukocyte count 0%.

Post-exertional values above normal limits are: K+ 7%, BUN 21%, creatinine 21%, CK 93%, LDH 86%, AST 0%, alkaline phosphatase 0%, bilirubin 14%, uric acid 36%, and leukocyte 71%. Consequently, abnormally high values for K+, BUN, creatinine, CK, LDH, bilirubin, uric acid, and leukocyte counts can often be expected in some patients who exercise heavily.

When should I be concerned about BUN creatinine ratio?

What causes a high BUN: Creatinine ratio? – What Does It Mean When Bun/Creatinine Ratio Is Low Amongst a few others, one major factor is dehydration. When the body is in a negative state of fluid balance, the kidney function gets affected. A high BUN: Creatinine ratio in this case indicates dehydration but the good news is that it is reversible. Drinking enough fluids can improve the high BUN: Creatinine ratio. A high BUN/Creatinine ratio can also be due to an ongoing kidney problem. In this regard, both BUN and creatinine are elevated modestly or proportionately, and the ratio hence is not necessarily higher than 20. Let’s take an example of dehydration below- A 70 kg individual who is 40 years old just ran 2 miles in the hot sun, and did not have anything to drink. Not even a glass of water. If we sampled his laboratories, his chemistry profile may look something like: BUN level of 28 mg/dl and creatinine of 1.1 mg/dl. Notice, that the BUN/Creatinine ratio in this case is higher than 20 indicating dehydration. Now if the same person had about 1 liter of water to drink during that run, the laboratories would look something like this: BUN of 16 mg/dl and creatinine of 0.95 mg/dl. Notice, in this case, the BUN/Creatinine ratio is not higher than 20 and BUN and creatinine have normalized. So, to summarize, the high BUN-Creatinine ratio, particularly if it is more than 20 and the person has a normal creatinine, usually indicates dehydration. However, if BUN and creatinine are both elevated significantly and the ratio is < 20, it may indicate an underlying kidney problem. Now let's take an example of kidney problem that can elevate the BUN and Creatinine levels- A 58 year old male who weighs about 70 kg has high BP and early diabetes. His laboratories show a BUN level of 29 mg/dl and a creatinine level of 1.6 mg/dl. He is adequately hydrated. In this regard, the BUN-Creatinine ratio is not higher than 20 and his BUN and creatinine levels are elevated in a "well-hydrated" state. This indicates he has an underlying kidney problem. Patients with chronic kidney disease from many causes (common being high BP, diabetes, etc.) are usually diagnosed with a BUN and creatinine test along with urine studies. Sometimes, imaging using an ultrasound or CT scans may be needed and are best directed by medical professionals.

Is Bun creatinine ratio more important?

The best, although indirect, measure of kidney function is indeed the creatinine, not the BUN. Blood, urea, nitrogen is used by nephrologists often to determine whether or not the patient is dehydrated. Generally speaking, the relationship between your creatinine and BUN is 1:10 relationship.