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High BUN indicates increased protein breakdown, which is associated with decreased immune function. A study shows that patients with elevated BUN (> 20 mg/dl) have an increased risk of infection (R). High BUN is associated with increased mortality in critically ill patients (R, R, R, R).
In cases of dehydration, BUN may increase in a higher proportion than the creatinine. A normal BUN-to-creatinine ratio is between 10 to 1 and 20 to 1. (For example, a BUN of 14 and a creatinine of 1.2 would be a ratio of 12.) In cases of dehydration, the BUN-to-creatinine ratio may be higher than 20 to 1, as the kidney responds by making the urine more concentrated. Other conditions that cause BUN-to-creatinine ratio to rise are kidney disease, kidney stones, or bleeding in the intestines.