High urea (azotemia): what it means and what to do

High urea and high azotemia are the same thing: there is more urea in your blood than normal. The cause is often simple, such as drinking too little or eating a lot of protein. Sometimes the kidneys are filtering less. To tell, your doctor looks at your creatinine.

What high urea means

Urea forms in your liver when your body uses protein, and your kidneys clear it. It rises if you make more, or if your kidneys clear less.

Creatinine helps tell them apart. High urea with a normal creatinine usually means too little water, a lot of protein or a medicine. If both rise, your kidneys may be filtering less.

How high it is matters too. Just above the limit is common and often settles on its own. Far above the limit should be seen by a doctor soon.

What causes high urea

There is often more than one. The most common come first.

Symptoms of high urea

Urea just above the limit usually causes no symptoms. If there are any, they come from the cause. For example:

If you vomit blood, have black stools or pass very little urine, call 112 or go to the emergency department.

High urea with a normal creatinine

This is the most common pattern, and usually the least worrying. Your kidneys filter well, but your body is making more urea or holding on to more.

Typical causes are too little water, a high-protein diet, steroids, or a spell of fever or hard exercise. Less often, bleeding in the stomach.

Your doctor often has the test repeated a few days later, once you have been drinking well and eating as usual.

Which tests to read alongside it

These tests help show where it comes from.

What your result means

The upper end of the scale, in mg/dL of urea. If your report says BUN, multiply by 2.14 first.

How to lower your urea

It depends on the cause. Where to start:

If your kidneys filter less, your doctor decides the treatment, sometimes with a kidney specialist. Drinking a lot is not enough, and in some cases it is not right.

High urea: when to worry

Talk to your doctor if:

Frequently asked questions

High urea with normal creatinine: what does it mean? Usually that your kidneys filter well, but you drank too little or ate a lot of protein. Steroids raise it too. Your doctor often has the test repeated.

Are high urea and high azotemia the same thing? Yes. Azotemia is the test that measures urea in the blood. If your report says BUN, the number is about half, but the meaning is the same.

When is high urea a worry? When it rises together with creatinine, when it stays high after drinking well, or when it is far above the limit. In those cases see your doctor soon.

Does drinking lots of water lower urea? If dehydration is the cause, yes: drinking well brings it down. If your kidneys filter less, drinking a lot is not enough, and with some heart or kidney conditions it is not right. Ask your doctor.

Does gym protein raise urea? Yes, a very high-protein diet or protein supplements raise it. Usually that is not kidney damage, but if your creatinine is high too, talk to your doctor.

Does high urea cause symptoms? Just above the limit, usually not. If it is very high for a long time, nausea, tiredness and itching can appear. Often the symptoms come from the cause, such as thirst or swollen legs.

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