What does a metabolic panel result indicating impaired renal function mean?

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From the Guidelines

This metabolic panel indicates moderate kidney impairment, corresponding to Stage 3a Chronic Kidney Disease, based on the elevated BUN and creatinine levels, and a decreased eGFR of 48 mL/min/1.73m², as defined by the National Kidney Foundation practice guidelines 1. The elevated BUN (Blood Urea Nitrogen) at 32 mg/dL and creatinine at 1.35 mg/dL, along with a decreased estimated glomerular filtration rate (eGFR) of 48 mL/min/1.73m², are key indicators of kidney function.

  • The high BUN/Creatinine ratio of 24 suggests possible pre-renal causes like dehydration or reduced blood flow to the kidneys.
  • According to the guidelines, a GFR level less than 60 mL/min per 1.73 m2 represents loss of half or more of the adult level of normal kidney function, and below this level, the prevalence of complications of chronic kidney disease increases 1.
  • The patient should consult with a healthcare provider promptly for further evaluation, which may include additional blood tests, urinalysis, and possibly kidney imaging.
  • Treatment typically focuses on addressing underlying causes, managing blood pressure, adjusting medications that may affect kidney function, and possibly dietary modifications to limit protein, sodium, and potassium intake, as recommended by the National Kidney Foundation practice guidelines 1.
  • Regular monitoring of kidney function will be necessary to track any progression or improvement in these values, and to prevent adverse outcomes such as death and cardiovascular disease, which are associated with decreased GFR 1.

From the Research

Metabolic Panel Results

The provided metabolic panel results indicate the following:

  • BUN (Blood Urea Nitrogen) level is 32 mg/dL, which is higher than the normal range of 6-24 mg/dL 2
  • Creatinine level is 1.35 mg/dL, which is higher than the normal range of 0.57-1.00 mg/dL 2
  • eGFR (estimated Glomerular Filtration Rate) is 48 mL/min/1.73, which is lower than the normal range of >59 mL/min/1.73 2
  • BUN/Creatinine Ratio is 24, which is higher than the normal range of 9-23

Implications of the Results

The low eGFR value may indicate impaired kidney function, which can increase the risk of cardiovascular disease 2.

  • A lower eGFR is associated with a higher risk of heart failure and atherosclerotic cardiovascular disease events 2
  • The rate of decline in eGFR is also a significant predictor of cardiovascular risk 2 However, it is essential to consider these results in the context of the individual's overall health and medical history.
  • The BUN and creatinine levels should be evaluated in conjunction with other laboratory results and clinical findings to determine the underlying cause of the abnormal results.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study.

American journal of kidney diseases : the official journal of the National Kidney Foundation, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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