Clinical settings when BUN and creatinine levels may not reflect alteration in renal function High urea with normal renal function: Hypercatabolism, high protein load, GI bleed, hematoma breakdown Normal urea with decreased renal function: Decreased urea synthesis in hepatic failure or malnutrition High creatinine with normal renal function: Excess creatinine release due to seizures, muscle injury, inflammation, or ischemia Normal creatinine with decreased renal function: Decreased creatinine synthesis from muscle due to malnutrition or atrophic muscular disorders
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