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January 7, 1974, Vol 227, No. 1 >
ARTICLE | January 7, 1974

Evaluation of Chronic Uremia: Title and subTitle BreakImportance of Serum Urea Nitrogen, Serum Creatinine, and Their Ratio FREE

Joel D. Kopple, MD; Jack W. Coburn, MD
[+] Author Affiliations

Reprint requests to VA Wadsworth Hospital Center, Wilshire and Sawtelle boulevards, Los Angeles 90073 (Dr. Kopple).


JAMA. 1974;227(1):41-44. doi:10.1001/jama.1974.03230140015003
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References

In chronically uremic men receiving carefully controlled diets of varying protein intake during metabolic study, the ratio of serum urea nitrogen (SUN) to serum creatinine correlated closely with protein intake. This ratio was altered abruptly by even minor catabolic stresses or dehydration. The ratio of SUN to creatinine can be used to estimate the daily protein intake and can indicate the presence of unrecognized catabolic stress. Knowledge of its relation to protein intake can be used to determine the degree of protein restriction required to achieve a certain SUN level. In subjects undergoing periodic hemodialysis, SUN-serum creatinine ratios were lower, and the SUN level was a better indicator of dietary protein intake than the SUN-creatinine ratio.

REFERENCES

1 +
Doolan PD:  Nitrogen excretion in renal failure , in Brest AN, Moyer JH (eds): Renal Failure . Philadelphia, JB Lippincott Co, 1967;, pp 137-140.
2 +
Wesson LG Jr: Physiology of the Human Kidney . New York, Grune and Stratton, Inc, 1969;, pp 632-655.
3 +
Möller E, McIntosh JF, Van Slyke DD:  Studies of urea excretion: II. Relationship between urine volume and the rate of urea excretion by normal adults . J Clin Invest 6:427-465, 1928;.
4 +
Möller E, McIntosh JF, Van Slyke DD:  Studies of urea excretion: IV. Relationship between urine volume and rate of urea excretion by patients with Bright's disease . J Clin Invest 6:485-504, 1928;.
5 +
Marshall S:  Urea-creatinine ratio in obstructive uropathy and renal hypertension . JAMA 190:719-720, 1964;.
6 +
Dossetor JB:  Creatininemia versus uremia . Ann Intern Med 65:1287-1299, 1966;.
7 +
Schreiner GE, Maher JF: Uremia: Biochemistry, Pathogenesis and Treatment . Springfield, Charles C Thomas Publisher, 1961;, pp 91-97.
8 +
Kopple JD, Coburn JW:  Metabolic studies of low protein diets in uremia: I. Nitrogen and potassium . Medicine , to be published.
9 +
Kopple JD, et al:  Optimal dietary protein treatment during chronic hemodialysis . Trans Am Soc Artif Intern Organs 15:302-307, 1969;.
10 +
Kopple JD, Coburn JW, Rubini ME:  Nitrogen requirements in chronic uremia , in Kluthe R, Berlyne G, Burton B (eds): Uremia, An International Conference on Pathogenesis, Diagnosis and Therapy . Stuttgart, Germany, Georg Theime Verlag, 1972;, pp 271-281.
11 +
Berlyne GM, Shaw AB, Nilwarangkur S:  Dietary treatment of chronic renal failure: Experiences with a modified Giovannetti diet . Nephron 2:129-147, 1965;.
12 +
Shaw AB, et al:  The treatment of chronic renal failure by a modified Giovannetti diet . Q J Med 34:237-253, 1965;.
13 +
Kopple JD, et al:  Evaluating modified protein diets for uremia . J Am Diet Assoc 54:481-485, 1969;.
14 +
Wolf AV, et al:  Artificial kidney function: Kinetics of hemodialysis . J Clin Invest 30:1062-1070, 1951;.
15 +
Jones JD, Burnett PC:  Implication of creatinine and gut flora in the uremic syndrome: Induction of "creatininase" in colon contents of the rat by dietary creatinine . Clin Chem 18:280-284, 1972;.

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1 +
Doolan PD:  Nitrogen excretion in renal failure , in Brest AN, Moyer JH (eds): Renal Failure . Philadelphia, JB Lippincott Co, 1967;, pp 137-140.
2 +
Wesson LG Jr: Physiology of the Human Kidney . New York, Grune and Stratton, Inc, 1969;, pp 632-655.
3 +
Möller E, McIntosh JF, Van Slyke DD:  Studies of urea excretion: II. Relationship between urine volume and the rate of urea excretion by normal adults . J Clin Invest 6:427-465, 1928;.
4 +
Möller E, McIntosh JF, Van Slyke DD:  Studies of urea excretion: IV. Relationship between urine volume and rate of urea excretion by patients with Bright's disease . J Clin Invest 6:485-504, 1928;.
5 +
Marshall S:  Urea-creatinine ratio in obstructive uropathy and renal hypertension . JAMA 190:719-720, 1964;.
6 +
Dossetor JB:  Creatininemia versus uremia . Ann Intern Med 65:1287-1299, 1966;.
7 +
Schreiner GE, Maher JF: Uremia: Biochemistry, Pathogenesis and Treatment . Springfield, Charles C Thomas Publisher, 1961;, pp 91-97.
8 +
Kopple JD, Coburn JW:  Metabolic studies of low protein diets in uremia: I. Nitrogen and potassium . Medicine , to be published.
9 +
Kopple JD, et al:  Optimal dietary protein treatment during chronic hemodialysis . Trans Am Soc Artif Intern Organs 15:302-307, 1969;.
10 +
Kopple JD, Coburn JW, Rubini ME:  Nitrogen requirements in chronic uremia , in Kluthe R, Berlyne G, Burton B (eds): Uremia, An International Conference on Pathogenesis, Diagnosis and Therapy . Stuttgart, Germany, Georg Theime Verlag, 1972;, pp 271-281.
11 +
Berlyne GM, Shaw AB, Nilwarangkur S:  Dietary treatment of chronic renal failure: Experiences with a modified Giovannetti diet . Nephron 2:129-147, 1965;.
12 +
Shaw AB, et al:  The treatment of chronic renal failure by a modified Giovannetti diet . Q J Med 34:237-253, 1965;.
13 +
Kopple JD, et al:  Evaluating modified protein diets for uremia . J Am Diet Assoc 54:481-485, 1969;.
14 +
Wolf AV, et al:  Artificial kidney function: Kinetics of hemodialysis . J Clin Invest 30:1062-1070, 1951;.
15 +
Jones JD, Burnett PC:  Implication of creatinine and gut flora in the uremic syndrome: Induction of "creatininase" in colon contents of the rat by dietary creatinine . Clin Chem 18:280-284, 1972;.

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