The blood urea nitrogen (BUN) to creatinine ratio is a clinical laboratory assessment used to evaluate kidney function and hydration status. It is derived by dividing the concentration of BUN in milligrams per deciliter (mg/dL) by the concentration of creatinine in mg/dL. For example, if a patient has a BUN level of 20 mg/dL and a creatinine level of 1 mg/dL, the ratio is calculated as 20/1, resulting in a ratio of 20:1.
This ratio provides insights beyond the individual BUN and creatinine levels. It aids in distinguishing between different types of kidney problems, such as pre-renal (related to blood flow to the kidneys), intrinsic renal (related to kidney damage itself), and post-renal (related to blockage of urine flow). Elevated ratios may indicate dehydration, heart failure, or gastrointestinal bleeding, while decreased ratios can sometimes be seen in liver disease or malnutrition. Historically, the ratio has been a useful tool in the diagnostic workup of renal dysfunction since the measurement of BUN and creatinine became commonplace in clinical chemistry.