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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).
1 A high BUN may be caused by impaired kidney function, congestive heart failure, urine flow obstruction, shock, recent heart attack, dehydration, a high protein diet, or gastrointestinal bleeding. 2  A low BUN is not common but can be found incidentally with malnutrition, severe liver disease or in overhydration.