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Blood urea nitrogen (BUN) may be due to prerenal causes (cardiac decompensation, water depletion due to decreased intake and excessive loss, increased protein catabolism, and high protein diet), renal causes (acute glomerulonephritis, chronic nephritis, polycystic kidney disease, nephrosclerosis, and tubular necrosis), and postrenal causes (eg, all types of obstruction of the urinary tract, such as stones, enlarged prostate gland, tumors). Serum blood urea nitrogen (BUN) determinations are considerably less sensitive than BUN clearance (and creatinine clearance) tests, and levels may not be abnormal until the BUN clearance has diminished to less than 50%. Clinicians frequently calculate a convenient relationship, the urea nitrogen:creatinine ratio-serum BUN in mg/dL/serum creatinine in mg/dL.
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