The diagnostic value of serum urea/creatinine ratio in distinguishing between upper and lower gastrointestinal bleeding. A prospective study

Dan Med Bull. 1994 Apr;41(2):237-40.


The predictive value of a urea/creatinine ratio > or = 100 for indicating upper gastrointestinal bleeding was evaluated in 78 consecutive patients with a history of gastrointestinal bleeding 24 hours or less before admission. Serum beta-2-microglobulin was measured to elucidate whether renal hypoperfusion plays a part in elevation of the urea/creatinine ratio. The predictive value of a urea/creatinine ratio > or = 100 in terms of upper gastrointestinal bleeding, was 95% (95% confidence interval (CI): 83-99%), whereas the predictive value of a urea/creatinine ratio < 100, indicating lower gastrointestinal bleeding, was 41% (CI: 25-59%). No statistically significant differences were found between serum beta-2-microglobulin levels in upper and lower gastrointestinal bleeders. We conclude that a urea/creatinine ratio > or = 100 strongly indicates an upper gastrointestinal bleeding source and that the main cause of a high ratio is not renal hypoperfusion.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Creatinine / blood*
  • Female
  • Gastrointestinal Hemorrhage / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Urea / blood*


  • Urea
  • Creatinine