Difference between revisions of "Urea"
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==Description== | ==Description== | ||
Urea is a form of nitrogenous waste formed from [[Ammonia|ammonia]] via the urea cycle in the liver. It freely crosses lipid membranes and is filtered into the glomerular filtrate in the renal glomerulus. A proportion of this filtered urea is reabsorbed passively before final excretion and it forms a vital of the concentration gradient needed to prevent passive diuresis. | Urea is a form of nitrogenous waste formed from [[Ammonia|ammonia]] via the urea cycle in the liver. It freely crosses lipid membranes and is filtered into the glomerular filtrate in the renal glomerulus. A proportion of this filtered urea is reabsorbed passively before final excretion and it forms a vital of the concentration gradient needed to prevent passive diuresis. | ||
+ | |||
+ | Urea is principally a product of amino acid deamination in the liver. Urea is primarily excreted by the kidneys and is the most commonly used test of renal function with creatinine. References: [[NationWide Laboratories]] | ||
==Clinical Significance== | ==Clinical Significance== | ||
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*Reduced synthesis with [[Portosystemic Shunt|porto-systemic shunts]], [[Hepatic Microvascular Dysplasia|microvascular dysplasia]] or liver failure. | *Reduced synthesis with [[Portosystemic Shunt|porto-systemic shunts]], [[Hepatic Microvascular Dysplasia|microvascular dysplasia]] or liver failure. | ||
*A diet with a low protein content or malnutrition. | *A diet with a low protein content or malnutrition. | ||
+ | |||
+ | == Small Animals == | ||
+ | |||
+ | === Increased urea, renal azotaemia === | ||
+ | |||
+ | * Acute renal failure | ||
+ | * Chronic renal failure | ||
+ | |||
+ | === Increased urea, prerenal azotaemia === | ||
+ | |||
+ | * Dehydration | ||
+ | * Shock | ||
+ | * High protein diet | ||
+ | * Fever | ||
+ | * Reduced cardiac output | ||
+ | * Hyperthyroidism | ||
+ | * Hypoadrenocorticism | ||
+ | * Gastrointestinal haemorrhage | ||
+ | |||
+ | === Increased urea, postrenal azotaemia === | ||
+ | |||
+ | * Feline urological syndrome | ||
+ | * Bladder rupture | ||
+ | * Calculi | ||
+ | * Neoplasia | ||
+ | * Perineal herniation | ||
+ | |||
+ | === Causes of a low urea concentration === | ||
+ | |||
+ | * Polydipsia/polyuria (due to causes other than renal disease) | ||
+ | * Hepatic insufficiency, especially portosystemic shunt | ||
+ | * Low protein diet | ||
+ | * Late pregnancy | ||
+ | * Anabolic steroids | ||
+ | |||
+ | === Complementary tests === | ||
+ | Creatinine and phosphorus. Urine specific gravity, urinalysis, glomerular filtration rate and SDMA. | ||
+ | |||
+ | == Equine == | ||
+ | |||
+ | === Increased urea, prerenal azotaemia === | ||
+ | |||
+ | * Dehydration | ||
+ | * Reduced renal perfusion | ||
+ | * Congestive heart failure | ||
+ | * Excessive muscle catabolism | ||
+ | * High protein diet | ||
+ | * Grass sickness | ||
+ | |||
+ | === Increased urea, renal azotaemia === | ||
+ | |||
+ | * Acute renal failure | ||
+ | * Chronic renal failure | ||
+ | |||
+ | === Increased urea, postrenal azotaemia === | ||
+ | |||
+ | * Obstruction, ruptured bladder | ||
+ | * Ruptured bladder in neonatal foals | ||
+ | * Low urea concentrations | ||
+ | * Hepatic insufficiency | ||
+ | * Young foals (normal by 60 days) | ||
+ | |||
+ | === Complementary tests === | ||
+ | Creatinine and phosphorus. Urine specific gravity (<1.020 in a dehydrated or azotaemic horse suggests renal tubular dysfunction). Urine clearance or fractional electrolyte excretion ratios (renal | ||
+ | |||
+ | tubular dysfunction). | ||
+ | |||
+ | Test Codes - Please visit www.nwlabs.co.uk or see our current price list for more information | ||
+ | |||
+ | == References == | ||
+ | Text referenced 'Nationwide Laboratories' [[NationWide Laboratories]] | ||
+ | |||
+ | Small Animals: [[NationWide Laboratories]] | ||
+ | |||
+ | Equine: [[NationWide Laboratories]] | ||
+ | |||
{{unfinished}} | {{unfinished}} | ||
[[Category:Blood Biochemistry Changes]][[Category:To_Do_-_Blood]] | [[Category:Blood Biochemistry Changes]][[Category:To_Do_-_Blood]] |
Revision as of 17:02, 17 March 2022
Also known as Blood Urea Nitrogen — BUN
Description
Urea is a form of nitrogenous waste formed from ammonia via the urea cycle in the liver. It freely crosses lipid membranes and is filtered into the glomerular filtrate in the renal glomerulus. A proportion of this filtered urea is reabsorbed passively before final excretion and it forms a vital of the concentration gradient needed to prevent passive diuresis.
Urea is principally a product of amino acid deamination in the liver. Urea is primarily excreted by the kidneys and is the most commonly used test of renal function with creatinine. References: NationWide Laboratories
Clinical Significance
An increase in serum concentrations of urea and creatinine is known as azotaemia and it is found almost exclusively in animals with kidney disease.
Blood urea coentration may be elevated independently of creatinine for the following reasons:
- Gastro-intestinal haemorrhage, as with gastro-duodenal ulceration.
- Diet with high protein or purine content, such as liver.
- Increased catabolism of body tissues, particularly muscle, which may occur in pyrexic animals or those with systemic disease.
Reduced urea concentration may occur due to:
- Over-enthusiastic fluid therapy, diluting the urea present in the blood.
- Disease that cause polyuria and/or polydipsia may cause 'medullary washout' of urea. Common examples include pyschogenic polydipsia, diabetes insipidus and Cushing's disease.
- Reduced synthesis with porto-systemic shunts, microvascular dysplasia or liver failure.
- A diet with a low protein content or malnutrition.
Small Animals
Increased urea, renal azotaemia
- Acute renal failure
- Chronic renal failure
Increased urea, prerenal azotaemia
- Dehydration
- Shock
- High protein diet
- Fever
- Reduced cardiac output
- Hyperthyroidism
- Hypoadrenocorticism
- Gastrointestinal haemorrhage
Increased urea, postrenal azotaemia
- Feline urological syndrome
- Bladder rupture
- Calculi
- Neoplasia
- Perineal herniation
Causes of a low urea concentration
- Polydipsia/polyuria (due to causes other than renal disease)
- Hepatic insufficiency, especially portosystemic shunt
- Low protein diet
- Late pregnancy
- Anabolic steroids
Complementary tests
Creatinine and phosphorus. Urine specific gravity, urinalysis, glomerular filtration rate and SDMA.
Equine
Increased urea, prerenal azotaemia
- Dehydration
- Reduced renal perfusion
- Congestive heart failure
- Excessive muscle catabolism
- High protein diet
- Grass sickness
Increased urea, renal azotaemia
- Acute renal failure
- Chronic renal failure
Increased urea, postrenal azotaemia
- Obstruction, ruptured bladder
- Ruptured bladder in neonatal foals
- Low urea concentrations
- Hepatic insufficiency
- Young foals (normal by 60 days)
Complementary tests
Creatinine and phosphorus. Urine specific gravity (<1.020 in a dehydrated or azotaemic horse suggests renal tubular dysfunction). Urine clearance or fractional electrolyte excretion ratios (renal
tubular dysfunction).
Test Codes - Please visit www.nwlabs.co.uk or see our current price list for more information
References
Text referenced 'Nationwide Laboratories' NationWide Laboratories
Small Animals: NationWide Laboratories
Equine: NationWide Laboratories
This article is still under construction. |