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The Follow-Up Metabolic Medicine Hospital Consultation
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
The blood urea nitrogen (BUN) is expected to increase when nutritional support is provided. Urea is an end product of protein catabolism. The main purpose of administering amino acids is to support protein synthesis. However, a portion of the protein provided will be burned as fuel, either directly or through gluconeogenesis. Even in a non-catabolic individual, roughly 30% of the protein provided meets this fate. The ratio is higher the more catabolic a patient becomes.
Nutrition
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
2.8. Which of the following may occur in a 2-week-old infant who has been fed on whole cows' milk?An elevated blood urea nitrogen.Dehydration.Convulsions.Elevated serum sodium.Low serum potassium.
General Approach To Upper Gastrointestinal Bleeding
Published in John P. Papp, Endoscopie Control of Gastrointestinal Hemorrhage, 2019
A normal serum creatinine will permit the conclusion that any blood urea nitrogen elevation is likely due to hypovolemia with reduced renal perfusion, absorption of urea from the small bowel, or both. The blood urea nitrogen value due to blood in the small bowel ranges from 20 to 80 mg/d/, but usually is less than 35mg/d/. Values in excess of 100 mg/d/ are indicative of intrinsic renal disease in addition to blood in the gut.
Ingestion of Sudan IV-adulterated palm oil impairs hepato-renal functions and induces the overexpression of pro-inflammatory cytokines: A sub-acute murine model
Published in Egyptian Journal of Basic and Applied Sciences, 2022
Ofem E. Eteng, Ceaser A. Moses, Emmanuel I. Ugwor, Joe E. Enobong, Adio J. Akamo, Yewande Adebekun, Arikpo Iwara, Eyong Ubana
Uric acid, BUN, and creatinine are clinically important biomarkers of kidney function. Uric acid is the byproduct of purine metabolism, while creatinine is produced by muscle (from creatine phosphate] and during protein catabolism. BUN is a measure of the amount of urea nitrogen present in the blood. Urea is a waste product of protein and amino acid, filtered by the kidneys into the urine. These markers are efficiently eliminated unchanged by the kidney, making them an important serum biomarker for kidney function [28]. Increased levels of these markers (as is the case in S4D-exposed rats) may result from decreased blood volume (hypovolemia) or decreased filtration rate by the kidneys [29]. Thus, the accumulation of these markers further affirms the impairment of renal function by S4D.
Targeted metabolomics as a tool for the diagnosis of kidney disease in Type II diabetes mellitus
Published in British Journal of Biomedical Science, 2021
S Abdelsattar, ZA Kasemy, M Elsayed, TA Elrahem, SK Zewain
Sustained hyperglycaemia in diabetes encourages fatty acid synthesis and triglycerides build-up causing lipid accumulation in ectopic non-adipose tissues playing a role in the pathogenesis of DKD [28,29]. Altered blood and muscle amino acid profile in DKD may be a cause of chronic inflammation and oxidative stress, leading to progressive renal disease so they have been proposed as nutritional markers for early renal dysfunction in diabetic patients [30]. In early DKD groups, the blood concentrations of the amino acids arginine, citrulline, and ornithine showed an increasing trend, most so by arginine. We speculate these may be related to increased levels of blood urea nitrogen in patients with early stages of renal insufficiency and thus enhanced urea cycle activity might be beneficial in cases of diabetic kidney disease [12]. Additionally, the current study revealed that the blood levels of valine and leucine:alanine significantly increased in linear trend over the three groups. This was in line with the study of Chuang et al [13] due to reduced take-up of branched chain amino acids, especially valine, into the muscles due to insulin resistance and decreased expression levels of adipose-tissue enzymes [31]. Regarding aromatic amino acids, phenylalanine and tyrosine showed a moderately increasing trend, as increased phenylalanine levels are related to higher macrovascular risk and mortality [32]. Raised concentrations of branched chain and aromatic amino acids were detected as predictors of diabetic kidney disease in a longitudinal liquid chromatography mass spectrometry (LC-MS)-based plasma metabolomic study [15].
Kidney physiology and pathophysiology during heat stress and the modification by exercise, dehydration, heat acclimation and aging
Published in Temperature, 2021
Christopher L. Chapman, Blair D. Johnson, Mark D. Parker, David Hostler, Riana R. Pryor, Zachary Schlader
Various other blood and urine markers can be used to inform interpretation of kidney function. Proteinuria, which can portend a reduction in GFR, can be assessed by measuring total protein or albumin in the urine [206]. Proteinuria may be indicative of increased glomerular permeability, a reduced capacity for reabsorption due to damage or dysfunction in the renal proximal tubules, or saturation of the renal tubules capacity for reabsorption due to overflow of normal or abnormal proteins that are produced in increased amounts [206]. Urine microscopy can be used to determine content of the urinary sediment, such as presence of erythrocytes (i.e., hematuria), casts, or crystals [206]. Blood urea nitrogen (BUN) is a metabolic waste product from dietary protein catabolism and turnover of tissue proteins, which increases in concentration with excessive tissue catabolism, such as fever or severe burns [206]. Measuring BUN may provide insight into potential dysfunction or pathology within the glomeruli. However, interpretation of increased BUN is limited during conditions eliciting increases in the tubular reabsorption of urea (e.g., decreased renal perfusion from heat stress). Kidney biopsies, although highly invasive and impractical for most experimental studies, can provide morphological assessment of the kidney, and have been previously used in suspected heat stress-related nephropathy in agricultural workers [207].