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[Value of the BUN/creatinine ratio in localizing digestive system hemorrhage in children]

G Prieto Bozano1, C Escribano Burgos, E Ortega Páez

  • 1Departamento de Pediatría, Hospital Infantil La Paz, Madrid.

Anales Espanoles De Pediatria
|March 1, 1990
PubMed

Insights

The blood urea nitrogen to creatinine (BUN/Cr) ratio effectively distinguishes upper from lower gastrointestinal bleeding in children. A BUN/Cr ratio over 30 suggests upper GI bleeding, aiding in diagnosis.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Diagnostics
  • Biomarker Research

Context:

  • Gastrointestinal bleeding is a common concern in pediatric patients.
  • Differentiating the source of bleeding (upper vs. lower GI tract) is crucial for appropriate management.
  • Existing diagnostic methods can be invasive or less definitive.

Purpose:

  • To evaluate the diagnostic utility of the blood urea nitrogen to creatinine (BUN/Cr) ratio in pediatric patients with gastrointestinal bleeding.
  • To determine if the BUN/Cr ratio can reliably differentiate between upper and lower gastrointestinal hemorrhage.
  • To assess the BUN/Cr ratio's effectiveness in identifying specific causes like gastroduodenal ulcers.

Summary:

  • A study involving 62 children with gastrointestinal bleeding analyzed BUN/Cr ratios.
  • Patients with upper GI hemorrhage exhibited mean BUN/Cr ratios of 30.85 (range 10–66.6), while lower GI bleeders had a mean of 20.12 (range 12.5–28).
  • A BUN/Cr ratio greater than 30 was observed in 18 patients with upper GI bleeding, and all lower GI bleeders had ratios below 30. Patients with gastroduodenal peptic ulcers showed the highest ratios.

Impact:

  • The BUN/Cr ratio serves as a valuable, non-invasive biomarker for distinguishing upper from lower gastrointestinal bleeding sources in children.
  • This ratio can aid clinicians in rapid diagnosis, particularly in cases of suspected gastroduodenal ulcers.
  • Improved diagnostic accuracy can lead to more timely and targeted therapeutic interventions.

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