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Urea (Blood Urea)

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Urea is the primary end product of protein metabolism. It constitutes approximately 50% of residual nitrogen in the body. Urea is synthesized in the liver through the Krebs cycle from amino acids. As an osmotically active substance, urea plays a critical role in the mechanism of urine concentration and is excreted from the body via the kidneys.

In clinical diagnostics, urea is used to evaluate the excretory function of the kidneys. The formation of urea in healthy individuals depends on their diet. Urea levels increase with the consumption of animal-based products (meat, fish, eggs, cheese, and cottage cheese) and decrease with a plant-based diet. In liver pathologies, a decrease in urea production may be observed. Children and pregnant women tend to have lower urea levels due to high protein synthesis. With age, urea levels generally increase.

This test is often used alongside creatinine and other kidney function markers for a comprehensive evaluation of renal health.

  • The test should be done after 8–14 hours of fasting.
  • It can also be performed 4 hours after a light meal.
  • A standard diet (avoiding excessive protein and purine intake) should be followed before the test.
  • Physical and emotional stress, as well as alcohol consumption, should be avoided prior to the test.
  • Liver and kidney function assessment
  • Renal failure
  • Liver failure

  • Renal Retentive Azotemia:

    • Glomerulonephritis
    • Renal amyloidosis
    • Pyelonephritis
    • Tuberculosis of the kidneys
    • Use of nephrotoxic drugs

  • Extrarenal Retentive Azotemia:

    • Heart failure
    • Massive bleeding
    • Shock
    • Intestinal obstruction
    • Burns
    • Dehydration

  • Productive Azotemia:

    • Cachexia
    • Leukemia
    • Malignant tumors
    • Use of glucocorticoids and androgens
    • Febrile conditions
    • Intense physical activity

               High-protein diet

Decreased Urea Levels

  • Liver Dysfunction:

    • Hepatitis
    • Liver cirrhosis
    • Acute hepatodystrophy
    • Hepatic coma
    • Phosphorus and arsenic poisoning

  • Other Causes:

    • Pregnancy
    • Vegetarian or low-protein diet, fasting
    • Acromegaly
    • Malabsorption
    • Hyperhydration
    • Post-dialysis state