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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).
Renal damage causes reduced reabsorption of BUN, therefore lowering the BUN:Cr ratio. An elevated BUN:Cr due to a low or low-normal creatinine and a BUN within the reference range is unlikely to be of clinical significance.