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Urea

Clinical significance

1) Physiologic changes in urea concentration
The concentration of urea depends on diet. The individuals taking food with high protein content have a higher serum urea concentration than those taking food with low protein content. Urea is normally lower in children and women because of their lower muscular mass than in men.

A) Increased levels
• in healthy individuals, the blood urea concentration increases with dietary protein,
• the concentration of urea increases with age,
• in late pregnancy because of increased protein intake.
B) Decreased levels
• blood urea concentration is lower in children during growth than in adults,
• in early normal pregnancy,
• in individuals on a low-protein high-carbohydrate diet

2) Pathologic changes in urea concentration
A) Increased urea levels in:
• Excessive urea production

- intake of high-protein diet 12 hours before blood sampling,
- enhanced catabolism of body protein.
• Incomplete urea clearance from the body
- renal failure,
- postrenal failure,
- prerenal failure,
• acquired hemolytic anemia (autoimmune) ,
• acute pancreatitis,
• acute poststreptococcal glomerulonephritis,
• acute renal failure,
• atherosclerosis,
• benign prostatic hypertrophy,
• bladder carcinoma,
• cholera,
• chronic lymphocytic leukemia,
• chronic pyelonephritis,
• chronic renal failure,
• congestive heart failure ,
• cystinosis
• diabetes mellitus,
• glomerulonephritis,
• glomerulonephritis, membranoproliferative,
• Goodpasture’s syndrome,
• gout,
• heavy chain disease (gamma),
• hepatic failure,
• hydronephrosis
• hyperthyroidism,
• IgA nephropathy,
• intestinal obstruction,
• lead poisoning,
• leptospirosis,
• liver cirrhosis,
• medullary cystic disease,
• multiple myeloma,
• nephrotic syndrome,
• non-Hodgkins lymphoma,
• polycystic kidney disease,
• pre-eclampsia,
• septicemia,
• shock,
• SLE,
• urethritis.
• vomiting,

B) Decreased urea levels in:
• acromegaly,
• acute and subacute necrosis of the liver,
• after glucose infusion,
• after hemodialysis,
• celiac disease,
• cystic fibrosis,
• eclampsia,
• hepatic failure.
• hepatolenticular degeneration,
• Laennec’s or alcoholic cirrhosis,
• liver cirrhosis,
• liver disease,
• nephrotic syndrome,
• pre-eclampsia,
• protein malnutrition,
• toxic hepatitis,