Diagnostic Utility of Urea-to-Creatinine Ratio as a Screening Biomarker for Renal Dysfunction and Hemoconcentration

Abstract

Background: Evaluating the urea-to-creatinine ratio provides a dependable, non-invasive avenue for clinicians to discriminate functional pre-renal azotemia often secondary to intravascular volume depletion or acute hemoconcentration from true intrinsic parenchymal kidney damage. On a global scale, impaired renal function continues to impose a heavy clinical burden, driving up patient morbidity, overall mortality rates, and healthcare system utilization.

Objective: To evaluate the screening efficacy of the urea-to-creatinine ratio in identifying early renal clearance deficits, while characterizing its physiological variations across age and sex demographics.

Methods: Utilizing a cross-sectional analytical framework, clinical profiles from 561 subjects (323 males, 238 females; age range: 1–103 years) were analyzed. Serum concentrations of urea and creatinine were quantified, and individual urea-to-creatinine ratios were computed as the dividend of urea to creatinine.

Results: Females demonstrated significantly higher mean UCR levels (44.79 ± 19.91) compared to males (37.66 ± 14.46). Pediatric (<18 years) and elderly (≥ 60 years) populations presented elevated UCR medians (46.74 and 38.93, respectively) indicating vulnerability to volume depletion.

Conclusion: The study reveals clear demographic-dependent variations in the urea-to-creatinine ratio, characterized by significantly higher baseline levels in females (44.79 ± 19.91) than males (37.66 ± 14.46), tied to muscle mass differences. Furthermore, pediatric (<18 years, median: 46.74) and elderly (more than 60 years, median: 38.93) cohorts demonstrate distinct susceptibility to elevated ratios, underscoring their vulnerability to fluid loss and hemoconcentration.