Blood urea nitrogen level: Effectiveness for severity assessment in acute

Remarkable efforts have been made to find predictive combinations of clinical and laboratory parameters to identify patients suffering from severe acute pancreatitis early in the course of the disease. Several complex scoring systems have proven to be useful to stratify patients into risk categories. However, frequently encountered limitations to scoring systems remain, including limited availability of the required parameters outside of an intensive care setting and limited predictive value within the first day after admission. Single predictive laboratory parameters have been identified as an alternative, but few are currently available in routine clinical practice because measurement tools are sometimes expensive or not commonly available. A notable exception is blood urea nitrogen (BUN), which has recently been characterized as a valuable single predictor of prognosis in acute pancreatitis. Besides being quantifiable using a widely available and cheap routine measurement, timely monitoring of changes in BUN levels during the first day of admission has been shown to be as exact as complex scoring systems. This makes BUN an attractive candidate parameter for guiding clinical practice during the admission phase, and possibly also during later stages of the disease.