1. Estimation of Serum Urea Haematology lab Miss. Tahani Al Shehri

2. Objective 1. To estimate the concentration of urea in serum 2. To obtain experience in the use of kits

3. Introducton

4. Urea is nitrogen compound, formed almost solely in the liver From the catabolism of amino acids and is the main excretion product of protein metabolism

5. Introducton The concentration of urea in the blood serum represent mainly a balance between urea formation from protein catabolism and urea excretion by kidney.

6. Introducton If kidney fail, blood urea Conc. Increase to high level and toxic condition known as (Uremia ) will result. In uremia, urea must be removed from the blood by clinical procedure called “Blood Dialysis “

7. Introducton

8. Blood Urea Nitrogen (BUN) Some time used as measurement of serum urea ½ Mwt of Urea is Nitrogen Normal range Serum urea ( 10-50 ) mg/dl BUN ( 5- 25) mg/dl

9. Clinical calculator http://www.clinicalculator.com/homepage.htm

10. Clinical calculator

11. Serum urea normally vary depending on : Age ( due to change kidney function ) Sex ( conc. are slightly higher in men ) Diet ( protein diet Urea )

12. Abnormal condition Causes of high Serum urea 1. tissue protein catabolism (- ve N balance ) This occurs in : Fevers Wasting disease Thyrotoxicosis Diabetic coma After trauma or a major operation

13. Abnormal condition 2. Excess breakdown of blood protein Leukemia Release of leukocyte protein GIT Bleeding Hb & plasma protein can be released in to the gut

14. Abnormal condition 3. Diminished excretion of urea Pre-renal Eg, -Shock -congestive heart failure -Sodium depletion -Addison’s disease Renal disease Eg, Acute Glomerulonephritis Chronic heart failure Sever destructive renal disease Acute renal failure Hepatorenal syndrom Post-renal ُُ Eg, -Enlarge prostate Gland - Stone

15. Azotemia :- Is a term used for a high blood serum urea concentration Uraemia :- ( as opposed to Azotemia) Is the name given to the clinical syndrom that develops when there is nitrogen retention due to renal failure

16. Low Serum urea 1.Late pregnancy Due to : glomerluar filtration rate (GFR) Use of N by fetus Water retention 2. Liver disease 3.long term of protein malnutrition Increase rate of protein anabolism Long term replacement of blood loss with intravenous dextran or glucose or saline (Dilution )