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Non-Protein Nitrogen(NPN) Compounds. BUN-to-Creatinine ratio. The most likely cause is chronic renal disease. Supporting data are the essentially BUN/creatinine ratio and the significant elevation of all nonprotein nitrogen (NPN) values.
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The most likely cause is chronic renal disease. Supporting data are the essentially BUN/creatinine ratio and the significant elevation of all nonprotein nitrogen(NPN) values. • There was no significant improvement when cardiac function improved, further eliminating congestive heart failure as a cause of elevated BUN.
If the levels of acetone and other α-ketoacids were elevated, as might be found in diabetes, the patient’s elevated creatinine levels could have been an erroneous result. α-Ketoacids cause a positive bias when creatinine is measured by a kinetic Jaffe reaction, the most commonly used assay method. However, the normal glucose level and abnormal values for other NPN substances make this unlikely.
Increased uric acid is a result of the significant increase in nuclear breakdown in the presence of a high WBC. The increase is not from renal disease, because BUN and creatinine are normal. • Chemotherapy has reduced the WBC to below normal levels, and the patient is taking allopurinol.
It is probably due to decreased intake (patient is unable to eat); a determination of total serum protein and albumin would be helpful.