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Efficacy of measuring BUN in assessing children with dehydration due to gastroenteritis
W A Bonadio1, H H Hennes, J Machi
1Department of Pediatrics, Children's Hospital of Wisconsin, Milwaukee 53233.
Insights
Blood urea nitrogen (BUN) levels are not a reliable indicator for assessing dehydration in children with gastroenteritis. Most children in the study showed normal BUN concentrations despite significant dehydration symptoms.
Area of Science:
- Pediatrics
- Gastroenterology
- Nephrology
Background:
- Gastroenteritis and dehydration are common in children.
- Assessing hydration status is crucial for effective treatment.
- Blood urea nitrogen (BUN) is a commonly used marker for hydration.
Purpose of the Study:
- To evaluate the correlation between blood urea nitrogen (BUN) concentration and dehydration in pediatric gastroenteritis.
- To determine if BUN levels accurately reflect hydration status in this population.
Main Methods:
- Prospective study of 50 children with gastroenteritis and dehydration.
- Assessment of clinical dehydration signs, metabolic acidosis, and increased anion gap.
- Measurement of blood urea nitrogen (BUN) concentrations.
Main Results:
- 88% of children (44 out of 50) had normal BUN concentrations.
- Dehydration was evident through clinical signs and laboratory markers (metabolic acidosis, increased anion gap).
- BUN levels did not consistently correlate with the degree of dehydration.
Conclusions:
- Blood urea nitrogen (BUN) concentration is an inaccurate method for assessing hydration status in children with gastroenteritis-induced dehydration.
- Physiologic factors influencing BUN require further consideration in clinical practice.
Abstract:
We conducted a prospective study of 50 consecutive cases of children with gastroenteritis and dehydration to assess the correlation of alterations in the blood urea nitrogen (BUN) concentration. Symptoms included 24 children with vomiting and 26 with vomiting and diarrhea. All children were estimably dehydrated-appearing on examination by traditionally used criteria and had metabolic acidosis (serum bicarbonate concentration of less than 20 mEq/L) and increased anion gap (more than 12 mEq/L). Of these 50 children, 44 (88%) had a BUN concentration within the limits of normal--17 were less than or equal to 10 mg/dL, 17 were between 11 and 14 mg/dL, and ten were between 14 and 18 mg/dL. We discuss the physiologic factors that influence the BUN concentration in conditions of dehydration. Although commonly used, measurement of the magnitude of the BUN concentration is not an accurate method for assessing the hydration status of children with dehydration due to gastroenteritis.