BUN levels

INEFFECTIVE TISSUE PERFUSION RENAL The patient taking an aminoglycoside is at risk for nephrotoxicity. The nurse measures and records the intake and output and notifies the primary health care provider if the output is less than 750 ml/day. It is important to keep a record of the fluid intake and output as well as a daily weight to assess hydration and renal function. The nurse encourages fluid intake to 2000 ml/day (if the patient s condition permits). Any changes in the intake and output ratio or in the appearance of the urine may indicate nephrotoxicity. The nurse reports these types of changes to the primary health care provider promptly. The primary health care provider may order daily laboratory tests (ie, serum creatinine and blood urea nitrogen [BUN]) to monitor renal function. The nurse reports any elevation in the creatinine or BUN level to tiie primary health care provider because an elevation may indicate renal dysfunction. 

RISK FOR INEFFECTIVE TISSUE PERFUSION RENAL When the patient is taking a drag tiiat is potentially toxic to die kidneys, die nurse must carefully monitor fluid intake and output. In some instances, die nurse may need to perform hourly measurements of die urinary output. Periodic laboratory tests are usually ordered to monitor the patient s response to therapy and to detect toxic drag reactions. Seram creatinine levels and BUN levels are checked frequentiy during the course of therapy to monitor kidney function. If the BUN exceeds 40 mg dL or if the serum creatinine level exceeds 3 mg cIL, the primary health care provider may discontinue the drug therapy or reduce the dosage until renal function improves. 

Ammonia (NH3) is just one of the toxins implicated in HE. It is a metabolic by-product of protein catabolism and is also generated by bacteria in the GI tract. In a normally functioning liver, hepatocytes take up ammonia and degrade it to form urea, which is then renally excreted. In patients with cirrhosis, the conversion of ammonia to urea is retarded and ammonia accumulates, resulting in encephalopathy. This decrease in urea formation is manifest on laboratory assessment as decreased blood urea nitrogen (BUN), but BUN levels do not correlate with degree of HE. Patients with HE commonly have elevated serum ammonia concentrations, but the levels do not correlate well with the degree of central nervous system impairment.20... 

BUN) levels This is of clinical importance in patients with impaired renal function. With the exception of cl oxycy cline, tetracyclines should not be used in patients that are anuric. Doxycycline is excreted by the G1 tract under these conditions, and it will not accumulate in the serum of patients with renal insufficiency... 

The quantity of substance having an unknown structure is determined at 520 nm spectrophotometrically, while the normal BUN level is determined by averaging the BUN levels of a number of normal subjects. 

Enhanced BUN levels clearly signify a renal dysfunction, for instance urinary tract obstruction and nephritis i.e., inflammation of the kidney. 

Decreased BUN level is usually indicative of acute hepatic dysfunction and excessive dehydration,... 

A few important drugs, namely thiazide diuretics (e.g., chlorothiazide, hydroflumethiazide, bendroflumethiazide, benzthiazide, cyclothiazide etc.), neomycin, tetracyclines, methyldopa etc., help in enhancing the BUN levels perhaps due to interference with normal renal function,... 

Phenothiazines (e.g., promethazine, chlorpromazine, ethopropazine etc.) on the contrary causes a significant decrease in BUN levels due to lowering of urea production from the liver, and... 

Renal function /mpa/rmenf Anuria, acute or chronic renal insufficiency and evidence of diabetic nephropathy are contraindications because potassium retention is accentuated and may result in the rapid development of hyperkalemia. Do not give to patients with evidence of renal impairment (BUN greater than 30 mg/dL or serum creatinine greater than 1.5 mg/dL) or diabetes mellitus without continuous monitoring of serum electrolytes, creatinine, and BUN levels. 

Electrolyte imbalance and BUN increases Hyponatremia and hypochloremia may occur when amiloride is used with other diuretics. Increases in BUN levels usually accompany vigorous fluid elimination, especially when diuretic therapy is used in seriously ill patients, such as those who have hepatic cirrhosis with ascites and metabolic alkalosis, or those with resistant edema. 

Elevated BUN and serum creatinine It is not unusual for serum creatinine and BUN levels to be elevated during cyclosporine therapy. These elevations in renal transplant patients do not necessarily indicate rejection, and each patient must be fully evaluated before dosage adjustment is indicated. These increases reflect a reduction in the glomerular filtration rate. Impaired renal function at any time requires close monitoring, and frequent dosage adjustments may be indicated. The frequency and severity of serum creatinine elevations increase with dose and duration of cyclosporine therapy. These elevations are likely to become more pronounced without dose reduction or discontinuation. 

CBC, liver and renal function test results, urine output, BUN level, and serum alkaline phosphatase, bilirubin, and creatinine levels... 

BUN level blood chemistry test results and serum alkaline phosphatase, bilirubin, creatinine, AST (SCOT), and ALT (SGPT) levels to assess hepaticand renal function... 

Signs of overdosage include unusually elevated blood urea nitrogen (BUN) levels. 

Renal Effects. An elevated blood urea nitrogen (BUN) level was observed in an employee involved with mixing DNOC, refilling sprayer tanks with DNOC, and occasionally spraying DNOC for S weeks (Pollard and Filbee 1951). The patient s clinical history suggested that exposure was probably a combination of inhalation and dermal. 

Renal Effects. DNOC caused elevated BUN levels in a spray operator exposed to DNOC aerosols for 5 weeks (Pollard and Filbee 1951) and cloudy swelling of the kidney in one spray operator who died after drinking water contaminated with DNOC (Bidstrup and Payne 1951) and 6 workers occupationally exposed to DNOC for 2-8 weeks (Bidstrup and Payne 1951). DNOC also caused severe capillary hyperemia in the kidneys of a boy who died after an extremely large quantity of DNOC was accidentally applied to a skin rash (Buchinskii 1974). Therefore, the human data suggest that inhalation, oral, or dermal exposure to DNOC may cause renal effects. 

Hemolysis ean eause hyperkalemia, elevated laetate dehydrogenase, and hyperbilirubinemia 0 Renal failure ean eause elevated creatinine and blood urea nitrogen (BUN) levels 0 Hepatie transaminases may be elevated... 

Many important steps in nitrogen metabolism occur in the liver. Liver disease can be severe enough so that urea production may be compromised. Blood urea nitrogen (BUN) levels will decrease, and levels of the toxic compound ammonia will increase. Because the liver is involved in converting bilirubin to the diglucuronide that is excreted in the bile, the levels of bilirubin will increase in the body and jaundice will occur. When liver cells are damaged, enzymes such as aspartate transaminase (AST, also known as GOT, glutamate-oxaloacetate transaminase) will leak into the blood. 

Renal Effects. BUN levels were not elevated 4 hours after a man accidentally ingested a single 600 mg/kg dose of 1, 1, 1-trichloroethane (Stewart and Andrews 1966). 

Persistently elevated serum creatinine and BUN levels confound the perioperative management of renal transplant recipients. 

Blood urea nitrogen (BUN)— A waste product in the blood that comes from the breakdown of food protein. The kidneys filter blood to remove urea and thus maintain homeostasis. As kidney function decreases, the BUN level increases. 

Following synthesis, urea is transported in the bloodstream to the kidneys, which filter it for excretion. Measurements of blood urea nitrogen (BUN) levels provide a sensitive clinical test of kidney function, because filtration and removal of urea are impaired in cases of kidney malfunction. Analogously, blood ammonia measurements are a sensitive test of liver function. 

A decreased BUN level indicates the dialysis is effective but not the medication. 

Famotidine is reported not to affect cielosporin blood levels. " However, higher eielosporin blood levels were found in a study of heart transplant patients given famotidine. No significant changes in the pharmacoldnet-ies of eielosporin was seen in a single-dose study in 8 healthy subjects and no changes in serum ereatinine or BUN levels were seen in 7 kidney transplant patients."... 

As an example, let us consider a simple one-compartment model for the prescription of treatment protocols for dialysis by an artificial kidney device (Fig. 1.1). While fire blood irrea concentration (BUN) in the normal individual is usually 15 mg% (mg% = milligrams of the substance per 100 mL of blood), the BUN in irremic patients could teach SO mg%. The purpose of the dialysis is to bring the BUN level closer to the normal. In the artificial kidney, blood flows on one side of the dialyzer membrane and dialysate fluid flows on the other side. Mass transfer across the dialyzer membrane occurs by diffusion due to concentration difference across the membrane. Dilysate fluid is a makeup solution consisting of saline, ions, and the essential nutrients that maintains zero concentration difference for these essential materials across the membrane. However, during the dialysis, some hormones also diffuse out of the dialyzer membrane along with the urea molecule. Too-rapid dialysis often leads to depression in the individual because of the rapid loss of hormones. On the other hand, too-slow dialysis may lead to unreasonable time required at the hospital. 

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