What is being tested?

As protein is broken down by the body it forms toxic products, which need to be eliminated form the body. The liver converts these products to non-toxic urea. Urea is then circulated in the blood to the kidneys where it is eliminated from the body.

Healthy kidneys eliminate more than 90 per cent of the urea the body produces, so blood levels may indicate how well your kidneys are working.Also elevated during pregnancy

How is it used?

Urea and creatinine levels, together with electrolytes are used to evaluate kidney function and to monitor patients with various degrees of kidney failure or those receiving dialysis.

Patients of any age may undergo this test indicating the importance of the urea level as a part of the detoxification processes of the liver and excretory function of the kidneys.

When is it requested?

Urea may be used in a panel of tests:

• when someone has non-specific illness,
• as part of a routine testing panel, or
• to check how the kidneys are functioning before starting to take certain drugs.

Urea is often ordered with creatinine:

• if kidney problems are suspected,
• to monitor treatment of kidney disease, or
• to monitor kidney function while someone is on certain drugs.

What does the result mean?

High urea levels suggest impaired kidney function. This may be due to acute or chronic kidney disease. However, there are many things besides kidney disease that can affect urea levels such as decreased blood flow to the kidneys as in congestive heart failure, shock, stress, recent heart attack or severe burns; bleeding from the gastrointestinal tract; conditions that cause obstruction of urine flow; or dehydration.

Low urea levels are not common although they can be seen in severe liver disease or malnutrition but other tests can be used to diagnose or monitor these conditions. Low urea is also seen in normal pregnancy.

Is there anything else I should know?

Urea levels may increase with age and also with the amount of protein in your diet. High-protein diets may cause abnormally high urea levels. Very low-protein diets can cause abnormally low urea. Lower urea levels are also seen in infants and small children.

Drugs that impair kidney function may increase urea levels and monitoring of this test may be performed.

Common questions

• What other tests are used with urea to check how my kidneys are functioning?

Urea and creatinine are often the first tests that are used to check how well the kidneys are able to filter waste products from your blood.

A full U&E profile including electrolytes may allow further investigation of kidney function.

• How does urea change with age?

Urea levels increase with age. Urea levels in very young babies are about 2/3 of the levels found in healthy young adults, while levels in adults over 60 years of age are slightly higher than younger adults. Levels are also slightly higher in men than women.

• What happens to urea in pregnancy?

Urea levels are normally slightly lower in pregnancy, especially in the last few months when the fetus is using large amounts of protein for growth and blood volume has expanded.

More information

RCPA Manual: Urea

RCPA Manual: Urea urine