Discriminatory value of blood urea:creatinine ratio in upper gastrointestinal bleeding with and without cirrhosis of liver

Abstract

Aim: To evaluate the discriminatory ability of blood urea:creatinine ratio in upper gastro-intestinal bleeding (UGIB) with and without cirrhosis of liver.

Methods: Blood urea:creatinine (BU/CR) ratio in 160 adult patients of UGIB were studied after excluding clinically overt cirrhosis of liver, renal failure and hematochezia. All were subjected to ultrasonography of abdomen. Only those showing cirrhosis and portal hypertension (n=76) were taken up for liver biopsy to confirm the diagnosis. BU/CR ratio was compared to UGIB cases without cirrhosis of liver (n=84).

Results: The mean (+/- SD) blood urea creatinine ratio was significantly lower in the group with cirrhosis than without cirrhosis of liver (22.49 +/- 6.13 vs. 38.07 +/- 8.08, Z value 13.91).

Conclusion: In absence of renal failure, the blood urea/creatinine ratio may differentiate UGIB with associated cirrhosis of liver from those without. Being simple, cheap and readily available, it can be of some value in those patients with cirrhosis of liver clinically not associated with gross findings of cirrhosis. In our study it was also noted that, an arbitrary cut-off value of 30 showed considerable overlap between the two groups; hence this ratio may not always differentiate between the cirrhotics and non-cirrhotics. Therefore, reproducibility of these results needs further studies, taking into account other factors which can modify the BU level in our population.