TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: UEBF    
Urea Nitrogen, Body Fluid

Useful For Suggests clinical disorders or settings where the test may be helpful

Identifying the presence of urine as a cause for accumulation of fluid in a body compartment

 

Assessing adequacy of peritoneal dialysis treatment protocols

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Byproducts of nitrogen metabolism are present in high concentration in urine compared to blood and serve as a surrogate marker for the identification of urine leakage into a body compartment. Concentrations of creatinine or urea nitrogen that exceed the concentration found in a concurrent sample of blood are suggestive of the presence of urine.(1)

 

Peritoneal, abdominal, pelvic drain fluids:

Disruption of the urinary tract with subsequent leakage of urine into body cavities may be considered as part of the differential diagnosis when body fluid effusions develop of unknown origin.(2) Metabolites such as creatinine or urea that are contained in urine at high concentrations are good candidates to measure in body fluids for this investigation. Elevated concentrations may elicit a more focused radiologic examination to identify possible bladder rupture or perforation or the development of urinary fistula, which are typically corrected by surgical intervention.

 

Peritoneal dialysis fluid:

Peritoneal dialysis (PD) is a type of dialysis in which hyperosmotic fluid is passed into the patient's peritoneal cavity for a prescribed dwell time, wherein the peritoneum is employed as the dialysis membrane. The dwell fluid containing waste molecules removed by dialysis is drained and replaced with fresh fluid and the process repeated. Measurements of urea, creatinine, glucose, or other electrolytes in serum, urine, and the peritoneal dialysate fluid, aid in the assessment of peritoneal membrane transport characteristics and serve as markers of dialysis adequacy. Adequacy of PD is important to monitor because patients who maintain a sufficient clearance over time have longer survival.(2) Peritoneal urea clearance volume of distribution or urea (Kt/V) is calculated to measure solute clearance from the daily peritoneal urea clearance (Kt), and the volume of distribution of urea (V). Adequacy and membrane transport characteristics are calculated by plugging in the appropriate laboratory parameters into software packages used by dialysis centers.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

An interpretive report will be provided.

Interpretation Provides information to assist in interpretation of the test results

Peritoneal and drain fluid concentrations should be compared to serum or plasma. A fluid to serum ratio of greater than 1.0 suggests the specimen may be contaminated with urine.(1)

 

Peritoneal dialysate urea nitrogen concentrations can be used to calculate the adequacy of peritoneal dialysis by monitoring solute clearance over time.(3)

 

All other fluids: Results should be interpreted in conjunction with serum urea nitrogen and other clinical findings.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

In very rare cases, gammopathy, in particular type IgM (Waldenstrom macroglobulinemia), may cause unreliable results.

 

Ammonium ions may cause erroneously elevated results.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Manahan KJ, Fanning J: Peritoneal fluid urea nitrogen and creatinine reference values. Obstet Gynecol. 1999 May;93(5 Pt 1):780-782. doi: 10.1016/s0029-7844(98)00516-x

2. Block DR, Florkowski CM: Body fluids. In: Rafai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier;2018:chap 43

3. Canada-USA (CANUSA) Peritoneal Dialysis Study Group. Adequacy of dialysis and nutrition in continuous peritoneal dialysis: association with clinical outcomes. J Am Soc Nephrol. 1996;7:198-207