Elevated Blood Urea Nitrogen Is Associated With More Impaired Cardiac Performance and Poorer Long-Term Clinical Outcomes Independent of Glomerular Filtration Rate

2012 ◽  
Vol 18 (8) ◽  
pp. S12-S13
Author(s):  
Kevin Shrestha ◽  
Matthias Dupont ◽  
Allen G. Borowski ◽  
Richard W. Troughton ◽  
Allan L. Klein ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Clinical Outcomes ◽  
Blood Urea Nitrogen ◽  
Filtration Rate ◽  
Cardiac Performance ◽  
Elevated Blood ◽  
Urea Nitrogen ◽  
Elevated Blood Urea Nitrogen

Blood Urea Nitrogen Levels to Verify Estimated Glomerular Filtration Rate, as Derived from 2 Commonly Used Equations

2019 ◽  
Vol 50 (3) ◽  
pp. 298-305
Author(s):  
Sheng-Feng Lin ◽  
Hao-En Teng ◽  
Hsiu-Chen Lin
Keyword(s):  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Blood Urea Nitrogen ◽  
Filtration Rate ◽  
Urea Nitrogen ◽  
Disease Epidemiology ◽  
Nitrogen Levels ◽  
Ckd Stage

Abstract Background A blood urea nitrogen to creatinine ratio (BCR) of 20 or greater indicates various physiological conditions. Whether glomerular filtration rate (GFR) estimates obtained using the Modification of Diet in Renal Disease (MDRD) study equation and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) study equations are affected by a high BCR remains unknown. Methods Patients who underwent urine creatinine clearance (CrCl) and serum blood urea nitrogen (BUN) and creatinine assessments on the same day were enrolled in our study. Those with BCR of 20 or greater and less than 20 were categorized into high- and low-BCR groups. The concordance on diagnosing chronic kidney disease (CKD) stages by using urine CrCl level and serum GFR estimates was assessed. Results More disagreement in CKD stage diagnosis was observed in the high-BCR group (weighted κ = 0.600 and 0.541 for the MDRD and CKD-EPI study equations, respectively) than in the low-BCR group (weighted κ = 0.816 and 0.758, respectively). Conclusions A BCR of 20 or greater caused misestimation of the CKD stage. GFR estimates for patients with high BCR should be interpreted cautiously.

scholarly journals Blood urea nitrogen and risk of insulin use among people with diabetes

2018 ◽  
Vol 15 (5) ◽  
pp. 409-416 ◽  
Author(s):  
Yan Xie ◽  
Benjamin Bowe ◽  
Tingting Li ◽  
Hong Xian ◽  
Ziyad Al-Aly
Keyword(s):  
Glomerular Filtration Rate ◽  
Confidence Interval ◽  
Glomerular Filtration ◽  
Blood Urea Nitrogen ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Hazard Ratio ◽  
Urea Nitrogen ◽  
Increased Risk ◽  
Insulin Use

Laboratory evidence suggests that urea suppresses insulin secretion and sensitivity. Emerging epidemiologic evidence suggests that higher levels of urea are associated with increased risk of incident diabetes mellitus. However, whether elevated levels of blood urea nitrogen are associated with increased risk of insulin use among people with diabetes is unknown. We used the Department of Veterans Affairs databases to assemble a cohort of 197,994 incident users of non-insulin hypoglycaemic agents with an estimated glomerular filtration rate > 60 mL/min per 1.73 m2 and followed them for a median of 4.93 years. Spline analyses suggested that the relationship between blood urea nitrogen and the risk of insulin use was neutral below blood urea nitrogen level of 25 mg/dL and increased exponentially with blood urea nitrogen levels above 25 mg/dL. In survival models, compared to those with blood urea nitrogen ⩽ 25 mg/dL, those with blood urea nitrogen > 25 mg/dL had an increased risk of insulin use (hazard ratio = 1.40; confidence interval = 1.30–1.50). The risk of insulin use was increased in models which accounted for haemoglobin A1c at time zero (hazard ratio = 1.39; confidence interval = 1.28–1.50) and as a time-varying variable (hazard ratio = 1.38; confidence interval = 1.28–1.50). Two-step residual estimation analyses showed that, independent of the impact of estimated glomerular filtration rate, every 10-mg/dL increase in blood urea nitrogen concentration was associated with increased risk of insulin use (hazard ratio = 1.16; confidence interval = 1.12–1.20). Our results suggest that, among people with diabetes, higher levels of blood urea nitrogen are associated with an increased risk of insulin use.

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