Understanding High Blood Urea Levels : Causes, Symptoms, and Treatment Options

After intake of food, the proteins present in it are broken down by the liver to produce urea. This urea is then absorbed by the blood and reaches the kidneys where most of it is filtered out. However, some amount of urea still remains in the blood which is of no specific clinical significance.^[1]

However, some people tend to have increased Blood Urea Levels. This is usually an indicator that either the liver or the kidneys are not functioning properly and also signifies the presence of an underlying medical condition.^[1]

A person with elevated blood urea levels will tend to have a variety of symptoms including weakness, fatigue, and appetite loss. In severe cases the person may also go into seizures or even coma.^[1] The article below highlights the primary causes and the underlying medical conditions that are responsible for elevated blood urea levels and the management options that are available to normalize them.

Below mentioned are some of the medical conditions that result in elevated Blood Urea levels.

Kidney Dysfunction: This is the primary culprit behind high blood urea levels. If the kidneys are not functioning properly the urea in the blood is not able to eliminated from the body and starts to accumulate in the blood. This is medically termed as hyperuricemia.^[2]

The kidney dysfunction may be caused due to an acute kidney injury, chronic renal dysfunction or other medications that impact the functioning of the kidneys like diabetes and cardiovascular illnesses.^[2]

Liver Dysfunction: This is yet another primary cause of high blood urea levels. It is the liver that first breaks down the protein to produce urea and nitrogen that gets absorbed in the blood. A person suffering from liver dysfunction like cirrhosis or hepatitis end up having elevated blood urea levels.^[3]

Cardiovascular Conditions: Congestive heart failure is one such medical condition which affects the way the kidneys work. This is because of the inability of the heart to pump in enough blood to the kidneys to work normally. As a result of this the kidneys are not able to eliminate excess urea thereby leading to elevated blood urea levels.^[4]

Dehydration: working out in the heat during peak summers can cause the body to lose a lot of fluids. If this lost fluid is not replenished then it leads to what is called as dehydration. When this occurs the levels of urea increases in the blood. Aside from being out in the heat diarrhea is also one of the leading causes of dehydration where the body loses plenty of fluids due to loose stools.^{[5, 9]}

Gastrointestinal Bleeding: Gastrointestinal conditions like peptic ulcer disease, esophageal varices or inflammatory bowel disease all tend to cause internal bleeding in the gastrointestinal tract. This leads to absorption of blood in the small bowel causing the blood urea levels to rise.^[6]

Cancer: It has been observed that people diagnosed with malignant conditions like leukemia or myeloma tend to have raised blood urea levels presumably due to death of cancer cells and also due to side effects of the drugs given to them for treatment of these cancers.^[7]

Aside from the medical conditions mentioned above there are also certain lifestyle factors that play a role in causing high blood urea levels. These factors include

Diet: Some people consume diet that is very high in protein which causes increased production of urea when the liver breaks these proteins down which raises the blood urea levels. In people who have known kidney impairment this excess urea is unable to be eliminated causing a variety of problems which require medical attention.^[8]

Rigorous Exercise: Rigorous exercising such as that seen with people involved with bodybuilding can lead to muscle breakdown which in turn increases blood urea levels in the body. Aside from bodybuilders athletes who indulge in intense training also can at times have high blood urea levels.^[10]

Medications: There are some medications which affect the levels of the blood urea. these medications include NSAIDs which are widely used for treatment of chronic pain and inflammation. Additionally, certain antibiotics and Ace inhibitors can also affect the functioning of the kidneys resulting in high blood urea levels.^{[11, 12]}

A person with a preexisting renal dysfunction must speak with the healthcare provider as which medications he or she should and should not take in order to keep the blood urea levels normal and avoid any potential side effects.^{[11, 12]}

Substance Abuse: People who are involved with recreational drug use especially heroin or cocaine frequently have high blood urea levels apart from the other dangerous effects that these drugs have on their overall health.^[13]

If a person goes to the healthcare provider and complains of symptoms that point towards a renal or liver dysfunction then he or she will be sent for a blood test. A sample of blood will be taken from the patient’s vein and sent to laboratory for testing. This test will determine the levels of blood urea nitrogen.^[14]

If the levels of blood urea is high then the physician will conduct further investigations to look for a potential cause for this. This will include targeted liver function tests, stress test, and other investigations to come up with a possible cause for high blood urea. Once a cause is identified a treatment plan is formulated for the patient.^[14]

If a chronic kidney dysfunction is responsible for the high blood urea then the patient may be sent for dialysis or in extreme cases kidney transplant may be recommended. If cardiovascular condition is believed to be the cause of high blood urea levels, then appropriate treatment will be formulated for the patient.^[14]

For conditions like dehydration replenishing fluids and electrolytes in the body is sufficient to bring back the blood urea levels to normal. In some cases, the patient may need to be put on medications to reduce the blood urea levels. Sodium is the medicine that is quite commonly used to get rid of any excess urea from the body.^[14]

Additionally, people with cardiac, liver, or renal conditions may need to be on a restricted diet to allow for these organs to function normally and keep the blood urea levels normal. Abstaining from doing rigorous exercise or abusing recreational drugs are also ways to keep the blood urea levels normal.^[14]

In conclusion, urea is produced by the liver when it breaks down the dietary protein. This urea then gets absorbed in the blood and reaches the kidney from where most of it is filtered out and eliminated from the body.^[1]

However, if the kidneys are not working normally then gradually the urea levels start to increase in the blood. Thus, Blood Urea is an important parameter to judge whether the kidneys are functioning normally or not. There are a variety of medical conditions and lifestyle factors that impact the functioning of the kidneys resulting in high blood urea levels.^[2]

All of these conditions and lifestyle factors have been illustrated above in detail. The levels of blood urea can be easily determined by doing a simple blood test. Once an underlying cause for the high blood urea level is identified then a treatment plan is formulated.^[14]

In most cases once the underlying cause is treated the blood urea level normalizes. In some cases, however, the patient may need medications to reduce the levels of blood urea.

Therefore, if a person has any symptoms that may point towards a renal impairment, then a consultation with a healthcare professional is needed to get to the bottom of the cause and come with an appropriate treatment strategy.^[14]

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