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

Sheng-Feng Lin, Hao-En Teng, Hsiu-Chen Lin

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalLaboratory Medicine
DOIs
Publication statusE-pub ahead of print - Mar 20 2019

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Blood Urea Nitrogen
Glomerular Filtration Rate
Chronic Renal Insufficiency
Urea
Blood
Nitrogen
Creatinine
Diet Therapy
Epidemiology
Nutrition
Urine
Kidney
Serum

Cite this

Blood Urea Nitrogen Levels to Verify Estimated Glomerular Filtration Rate, as Derived from 2 Commonly Used Equations. / Lin, Sheng-Feng; Teng, Hao-En; Lin, Hsiu-Chen.

In: Laboratory Medicine, 20.03.2019.

Research output: Contribution to journalArticle

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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.",
author = "Sheng-Feng Lin and Hao-En Teng and Hsiu-Chen Lin",
note = "{\circledC} American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
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AU - Lin, Sheng-Feng

AU - Teng, Hao-En

AU - Lin, Hsiu-Chen

N1 - © American Society for Clinical Pathology, 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2019/3/20

Y1 - 2019/3/20

N2 - 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.

AB - 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.

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