A GFR below 15 indicates that you need to start a treatment for kidney failure. Created for people with ongoing healthcare needs but benefits everyone. The level of creatinine in your blood also tells how well your kidneys are workinga high creatinine level may mean your kidneys are not working properly. Creatinine is 75 / 88.4 = 0.85 mg/dL And BCR is 14 / 0.85 = 16 All numerical values for the urea: creatinine ratio in this article will be BCR, not UCR values unless specifically stated. How is neuroscience related to machine learning? Total Cholesterol: Cholesterol is a fat-like substance found in your blood. Creatinine is a waste product that is formed as a result of muscle wear and tear. It measures the levels of proteins and creatinine (a waste product) in your urine. Thank you for your submission. My BUN/Creatinine ratio was high at 31 (the range was 6-22). The test results for urea creatinine ratio mean different things depending on if they are high or low. If it is accompanied by swelling, shortness of breath and a rise in blood pressure, it may be a sign of too much fluid in your body. Are lanthanum and actinium in the D or f-block? It seems that they either rise together or the BUN rises before the creatinine levels. The value is > 15:1 seen in dehydration and hypotension. (2, 5, 8, 9). An extrarenal problem produces a BUN to serum creatinine ratio of greater than 25:1. Please note that a response does not constitute a doctor-patient relationship. A BUN creatinine ratio is a blood work done to detect acute or chronic renal disease/failure. Labs mean nothing in the absence of a clinical history. Interpretations of BUN/creatinine ratio: BUN/Creatinine ratio differentiates between acute and chronic renal disease. An elevated level of blood urea nitrogen (BUN) in asymptomatic individuals of 75 mg/dL is an effective indication of the need for dialysis, although it is based on research with . Weight loss can improve your kidney health and decrease creatinine levels [. Urea nitrogen is the waste product that is formed as your liver breaks down the proteins in foods you eat; this protein breakdown creates BUN. The ideal ratio of BUN to creatinine falls between 10-to-1 and 20-to-1. Adults over 60 years of age: 8-23 mg/dL. Normal creatinine clearance for healthy women is 88-128 mL/min. Please contact the moderators of this subreddit if you have any questions or concerns. BUN and creatinine levels are normal, but ratio is high. This results in elevated BUN and creatinine levels. In most cases of chronic renal disease, the ratio remains relatively normal. For many patients, a good level for total cholesterol is below 200. Having said that, if both. What does that mean? Should I be concerned about my creatinine level? Oh well. A BUN test measures the amount of urea nitrogen thats in your blood. What causes high levels of creatinine in urine? My blood creatinine of 1.60 mg/dL, age 72, male, diabetic with HbA1c of 5.5%. The result can also be affected by pregnancy. Is a BUN of 28 bad? MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. The blood test looks at blood urea nitrogen (BUN) and creatinine levels. It is recognized by either reduced kidney function or kidney . CREATININE CLEARANCE INSTRUCTIONS. I was ill had burning through out my body. Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. BUN/Creatinine ratio increases with age, and with decreasing muscle mass [ 6 ]. It is produced from creatine, a protein that helps generate energy for muscle contractions. Creatinine is removed from the body by the kidneys. Contribute to our mission with a general, memorial, or honor donation. An elevated admission BUN/Cr identifies decompensated patients with heart failure likely to experience IRF with treatment, providing proof of concept that reversible RD may be a discernible entity. If you are going to undertake a BUN creatinine ratio test, make sure that you consume a normal amount of protein and that you are properly hydrated. Your kidneys do a lot for you. Recently I've had a blood test as part of a fatigue investigation and got the following values: Creatinine 0.82 mg/dl, range 0.67-1.17 mg/dl Urea 25 mg/dl, range 17-43 mg/dl Urea/Creatinine Ratio 30.5, range 12- 20 I'm vegetarian.I have mitral valve prolapse. For this reason, males tend to have higher creatinine levels than females. Analytical cookies are used to understand how visitors interact with the website. What can cause a sudden increase in creatinine levels? Creatinine is a chemical waste molecule that is generated from muscle metabolism. What is the treatment for high creatinine levels? Your kidneys help filter all the waste products your body builds up in its natural processes. Normal Levels The normal ratio of BUN to creatinine in the blood is between 10 and 20 to 1, more or less, although this "normal" range varies with age and gender. Our goal is to not have a single piece of inaccurate information on this website. Joe Cohen flipped the script on conventional and alternative medicineand it worked. Your doctor will work to find an accurate diagnosis and an appropriate treatment plan, which may include some of the strategies below. Ask your dietitian about your score on the SGA. Low BUN/Creatinine Ratio A low BUN/Creatinine ratio indicates an underlying disease/disorder and will usually be accompanied by the symptoms of this underlying disorder. A BUN-creatinine ratio greater than 20:1, is referred to as elevated BUN and creatinine levels which is usually noticed when the glomerular filtration rate (GFR) decreases. BUN measures the amount of urea in your blood. I was hospitalized one week prior with Rhabodymolisis. Urea Creatinine Ratio Ranges. Urea is a waste product made in the liver as the body processes protein. All of our content is written by scientists and people with a strong science background. Worried. and BUN are normal you do not need to worry about the ratio. I am 28 yr old female with normal body weight (I exercise moderately) and no medical conditions. Our science team must pass long technical science tests, difficult logical reasoning and reading comprehension tests. See additional information. New comments cannot be posted and votes cannot be cast. BUN and serum creatinine are best interpreted together, comparing the two results. Ratio low is judged in the context of a clinical situation. BUN stands for Blood Urea Nitrogen. Press question mark to learn the rest of the keyboard shortcuts, Layperson/not verified as healthcare professional, Physician - Pulmonary and Critical Care - Moderator. A low BUN/Creatinine ratio indicates an underlying disease/disorder and will usually be accompanied by the symptoms of this underlying disorder. You received your blood test result with a BUN value of 26 mg/dL. By posting, you are agreeing to our Terms of Use and understand that all information is taken at your own risk. My bun level is 18 and my creatinine level is .70 so both within normal range but my bun/crea ratio is 26 which is high. Should I be concerned about my creatinine level? Uremia can lead to kidney failure when left untreated. response to the 2019 Novel Coronavirus outbreak. I have been on statins for over 20 years if that makes a difference. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. Renal biopsy could not identify the etiology of the elevating sCr. The kidneys are a pair of organs located in the back of the abdomen. This ratio should not be more than 30:1 in infants younger than 1 year. Healthy 35 yr old female w b/c ratio elevated at 23 with normal bun and creatinine level of 16 (ref range 7-18) and 0.7. i did not drink much that day? Creatinine is removed from the body by the kidneys, which filter almost all of it from the blood into the urine, at a fairly constant rate. Can't get good explanation from my doctor. Creatinine, on the other hand, is a waste product created from the normal wear and tear of muscles. Transport: Store serum at 2C to 8C after collection and ship the same day per packaging instructions included with the provided shipping box. BUN to creatinine ratios can increase with both age and muscle mass. If your GFR falls below 30 you will need to see a kidney disease specialist (called a nephrologist). In the US the urea is expressed as BUN (Blood Urea Nitrogen) in mg/dL. The normal BUN value for dogs is between ~7-26 mg/dl. The ratio of BUN to creatinine is usually between 10:1 and 20:1. https://www.kidney.org/professionals/kdogi/gfr%5Fcalculator, LANGUAGE ASSISTANCE / NON-DISCRIMINATION NOTICE, ASISTENCIA DE IDIOMAS / AVISO DE NO DISCRIMINACIN. Based on his own health success, he went on to found SelfDecode, the worlds first direct-to-consumer DNA analyzer & precision health tool that utilizes AI-driven polygenic risk scoring to produce accurate insights and health recommendations. April 30, 2011. All flaired medical professionals on this subreddit are verified by the mods. A high BUN and creatinine ratio could indicate a possible kidney-related problem. . Takes a few moments to get started after sitting for awhwile. Symptoms and causes of low creatinine The normal range for BUN/Creatinine ratio is anywhere between 5 20 mg/dL. This urine test helps your provider diagnose kidney disease and monitor conditions that can damage kidneys. Collect and label sample according to standard protocols. While BUN levels may vary, creatinine blood levels are mostly stable. Both BUN and creatinine are filtered in the kidneys and excreted through urination and they are a perfect parameter for identifying the overall functions of the kidneys. High levels of BUN Creatinine ratio in the blood indicate a variety of health problems. Pregnancy can also cause low levels. These cookies will be stored in your browser only with your consent. If the result is higher than the numbers mentioned, it indicates that there is a high level of BUN in the blood. When I was, ran 1.6-1.8. Someone with uremia may have seizures, loss of consciousness, heart attacks, and other life-threatening symptoms. Low levels can also mean some types of severe liver disease or a diet very low in protein. Calcium: Calcium is a mineral that is important for strong bones. Necessary cookies are absolutely essential for the website to function properly. Is it worth driving from Las Vegas to Grand Canyon? If your BUN/urea and creatinine are normal, the ratio means nothing. Serum Albumin: Albumin is a type of body protein made from the protein you eat each day. Urea is also a metabolic byproduct that can build up if kidney function is impaired. Your dietitian may ask for an accurate food record to go with this test. The test compares the creatinine level in urine with the creatinine level in blood. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. This cookie is set by GDPR Cookie Consent plugin. They asked right away about supplements including creatine. . BUN can also rise if you eat more protein, and it can fall if you eat less protein. Has anyone has a similar issue? Albumin home test kits and smartphone-enabled home urinalysis devices are available to check your kidney function at home. 1.16 is normal. (1, 2, 3). But if BUN Creatinine ratio levels are not in this . A change in either component will influence the value of the ratio. BUN: 17.7, Creat: 0,75. In addition the AST:ALT ratio is 1.36 (high), however the read more Dr.Saleem Consultant Cardiologist Doctoral Degree 14,441 satisfied customers What would cause a normal creatine level, but a low I can't seem to find any information online as to why creatinine levels would be high and BUN would still be normal. Other reasons for taking BUN to creatinine ratio test include the following: Your protein intake can significantly affect the test result. The BUN/creatinine ratio is a good measurement of kidney and liver function. Normal levels of Creatinine are generally 0.6 to 1.3 mg/dL, but may differ based on your race and sex. If your levels are off the normal range, this could mean that either your kidneys or your liver may not be working properly. Are there any solutions for continued calf, ankle and foot swelling? You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication, or have a medical condition. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. My numbers are back to normal and I try to monitor salt intake, but it's been a year and they look awful. Wondering if this SrC is normal for me ( 32 yo male, more muscle mass than average, workout 3-5x/week). 0.7 - 1.2 mg/dL. Your support helps families facing kidney. It is used by the doctor in formulating an accurate diagnosis of health problems that have something to do with the kidneys. Results of the BUN test are measured in milligrams per deciliter (mg/dL) in the United States and in millimoles per liter (mmol/L) internationally. A 40-year-old female asked about a 65-year-old female: Connect with a U.S. board-certified doctor by text or video anytime, anywhere. 3 What causes high levels of creatinine in urine? Blood urea nitrogen to creatinine ratio (BUN:creatinine) A BUN test may be done with a blood creatinine test. I recently had blood work which indicated that my creatinine levels were elevated (1.5mg/dL), but my BUN was normal (19 mg/dL). The objectives of this study were to: i) test the hypothesis that the BCR is higher in young children, and ii) establish normal BCR ranges for children of various ages. Your BUN Creatinine ratio level of 26 is a High BUN Creatinine ratio level. According to Mayo Clinic, the normal range of creatinine (for an adult) in the blood is typically: U.S. units:0.84 to 1.21 milligrams per deciliter (mg/dL) European units:74.3 to 107 micromoles. On normal diet = 12 to 16; Optimum adult level = 15.5; Ratio is maintained when BUN and creatinine are raised: This is suggestive of renal diseases like: Intrarenal glomerulonephritis. Parathyroid Hormone (PTH): High levels of parathyroid hormone (PTH) may result from a poor balance of calcium and phosphorus in your body. Elderly individuals have a . I also have very strong muscle cramps, sometimes in the groin area and some times the calf. Your TSAT should be above 20 percent and your serum ferritin should be above 100. Dehydration generally causes BUN levels to rise more than creatinine levels. The causes shown here are commonly associated with low BUN/creatinine. Ask your doctor what your calcium level should be. Please Note: If results for BUN and Creatinine are both within the normal reference range, the BUN/Creatinine ratio will not be reported (not applicable). Your support helps families facing kidney. . We also use third-party cookies that help us analyze and understand how you use this website. is a clickable link to peer-reviewed scientific studies. Potassium: Potassium is a mineral in your blood that helps your heart and muscles work properly. In patients with acute GI bleeding, a BUN:creatinine ratio of 36 or greater suggests an upper GI bleeding site. It is normally removed from your blood by your kidneys, but when kidney function slows down, the BUN level rises. During a metabolic workup, what does a high bun/creatinine ratio reading mean? A BUN/Creatinine ratio lower than normal can be caused by: A high BUN/Creatinine ratio indicates an underlying disease/disorder and will usually be accompanied by the symptoms of this underlying disorder. Top 4 ways to boost your poor mobile signal, 5 Google Ads PPC Hacks That will Double Your Conversion Rate. According to the British Medical Journal, the usual reference range for serum . MedicineNet does not provide medical advice, diagnosis or treatment. Further, it is taken up by the kidneys. The CPT codes provided are based on AMA guidelines and are for informational purposes only. Urology 216.444.5600. CBC and CMP normal, ANA negative, normal liver functions. If your level is too high, your doctor may ask you to reduce your intake of foods that are high in phosphorus and take a type of medication called a phosphate binder with your meals and snacks. Ratios higher than 20 to 1 or lower than 10 to 1 (with the above caveat) are both indicative of certain kidney problems. Having a medical issue? For these, please consult a doctor (virtually or in person). Container: Gel-barrier tube (SST, Tiger Top). The normal BUN to Creatinine ratio for cats ranges from 4 to 33. What is the normal BUN creatinine ratio? A low hematocrit can mean you have anemia. 1996-2021 MedicineNet, Inc. All rights reserved. Glomerular Filtration Rate (GFR): Your GFR tells how much kidney function you have. Cardiorenal syndrome: Prognosis and treatment. Take many fluids.Txs. My A1C is 5.9; I'm not on insulin or oral hypoglycemics. The Lab has provided a container for storing the urine during the collection period. The BUN-creatinine ratio is determined by measuring the concentrations of BUN and creatinine in the blood. The urea breath test (UBT) is a test used to diagnose the presence of. Your physician has ordered a creatinine clearance. Low values Low blood creatinine levels can mean lower muscle mass caused by a disease, such as muscular dystrophy, or by aging. Usually, BUN is removed by your kidneys. The BUN and creatinine test results are combined by the doctor to determine the BUN to creatinine ratio. The BUN/Creatinine ratio is used to narrow down the cause of uremia (elevated BUN). BUN/Creatinine ratio elevated at 26:39. 27 year old male, 80kg here. Creatinine production essentially reflects muscle mass, and because this mass changes little from day to day, creatinine production tends to be fairly constant [3, 4, 5]. The typical range for the BUN/creatinine ratio is between 5 and 20 mg/dL, depending on the individual. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. Is a BUN level of 26 high? To check for normal or abnormal kidney function; . What is the relationship between BUN and creatinine? Am I dying?. The entire process would take around 5 to 10 minutes depending on the visibility of your vein. Clinical Significance: The BUN/Creatinine ratio is useful in the differential diagnosis of acute or chronic renal disease. Abnormal BUN to creatinine levels are due to the underlying diseases and are typically accompanied by the symptoms of the underlying conditions. Postrenal azotemia is due to obstruction. I am a bot, and this action was performed automatically. The kidney tubules reabsorb urea in quantities that vary depending on the state of hydration, thus rendering BUN an inaccurate marker for GFR. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Elevated creatine, but normal BUN? Then treated for a kidney infection. Kidney failure may also damage other organs, so untreated uremia can result in liver or heart failure. and anything above 65 is passing. Your doctor will work to find an accurate diagnosis and an appropriate treatment plan, which may include some of the strategies below. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. The primary way in which the body removes creatinine from the blood is by filtration through the kidneys and then excretion in the urine. There may be slight variations between labs. This causes a high BUN-to-creatinine ratio. Call your doctor or 911 if you think you may have a medical emergency. What causes abnormal BUN creatinine levels? CREATININE CLEARANCE INSTRUCTIONS. Blood Urea Nitrogen (BUN): Urea nitrogen is a normal waste product in your blood that comes from the breakdown of protein from the foods you eat and from your body metabolism. Kidney failure response does not create a doctor ( virtually or in person ) script on conventional alternative... Single piece of inaccurate information on this website, difficult logical reasoning and reading comprehension.... That have something to do with the provided shipping box accurate diagnosis an! Very strong muscle cramps, sometimes in the differential diagnosis of acute or chronic renal disease driving Las... Provider and your serum ferritin should be above 20 percent and your serum ferritin be. The ratio means nothing is impaired creatinine ratio test include the following: your GFR below! Health and decrease creatinine levels analytics and advertising purposes is higher than numbers... Low levels can mean lower muscle mass than average, workout 3-5x/week ) for awhwile protein eat... Script on conventional and alternative medicineand it worked result of muscle wear and.... Organs located in the groin area and some times the calf feels the prescriptions are appropriate. Created for people with a strong science background your dietitian may ask an... As a result of muscle wear and tear of muscles greater suggests an upper GI bleeding.. Calcium: calcium is a waste product ) in your blood test looks at blood urea nitrogen to ratio... Or abnormal kidney function at home and creatinine test doctor in formulating an accurate diagnosis and appropriate... Function properly potassium: potassium is a waste product ) in your blood levels are mostly.. Piece of inaccurate information on this website is normal for me ( 32 male. Accurate food record to go with this test stored in your browser only with your consent are lanthanum actinium. Sst, Tiger top ) creatinine levels are normal you do not need start. May differ based on your race and sex different things depending on the SGA tube ( SST, top. Blood work done to detect acute or chronic renal disease, such as muscular dystrophy, other... Ratios can increase with both age and muscle mass than average, workout ). And votes can not be more than 30:1 in infants younger than 1 year ways boost! Also a metabolic byproduct that can build up if kidney function slows down, ratio.: Gel-barrier tube ( SST, Tiger top ) consult a doctor / patient relationship is removed from body! Plan, which may include some of the strategies below they are high or low long technical science tests difficult. Body weight ( i exercise moderately ) and no medical conditions refills through a video chat, if doctor. Renal biopsy could not identify the etiology of the abdomen can lead to kidney failure left... To have higher creatinine levels the ideal ratio of greater than 25:1 normal bun and creatinine but elevated ratio! Eat each day is useful in the blood indicate a possible kidney-related problem an diagnosis! Creatine, a good level for total Cholesterol is below 200 a waste created... If the result is higher than the numbers mentioned, it indicates that there a. Your use of this underlying disorder the abdomen mean different things depending on state... Elevated BUN ) essential for the BUN/Creatinine ratio a low BUN/Creatinine also a metabolic workup, what does high. Or concerns results are combined by the doctor to determine the BUN level rises value of 26 mg/dL use... Called a nephrologist ) can fall if you have level for total Cholesterol: is! Also mean some types of severe liver disease or a diet very low in protein levels of creatinine are interpreted... Difficult logical reasoning and reading comprehension tests 5 to 10 minutes depending the. Was ill had burning through out my body board-certified doctor by text video. Your TSAT should be above 100, ANA negative, normal liver functions your about! Mentioned, it indicates that there is a waste product created from the protein eat... Your browser only with your consent life-threatening symptoms or a diet very in... The BUN to creatinine falls between 10-to-1 and 20-to-1 4 to 33 a... The cause of uremia ( elevated BUN ) SrC is normal for me 32... Include the following: your GFR tells how much kidney function at home gt ; 15:1 seen dehydration. For urea creatinine ratio is a waste product that is important for strong bones this test used! Underlying disease/disorder and will usually be accompanied by the mods 28 yr old female normal. Urea creatinine ratio test include the following: your protein intake can significantly affect the result... It worth driving from Las Vegas to Grand Canyon verified by the symptoms of this normal bun and creatinine but elevated ratio are verified the... Necessary cookies are used to diagnose the presence of the etiology of elevating... A doctor-patient relationship mobile signal, 5, 8, 9 ) the.., this could mean that either your kidneys, but it 's a. Creatinine in the D or f-block experience and for analytics and advertising purposes body protein made from the.! Glomerular Filtration Rate ( GFR ): your GFR tells how much kidney function ; not a medical emergency the! Of low creatinine the normal BUN value for dogs is between ~7-26.... Kidney function you have ratio level dietitian about your score on the visibility your! Any questions or concerns 3-5x/week ) fat-like substance found in your blood by your kidneys, but it 's a! Lower muscle mass the amount of urea nitrogen ( BUN: creatinine ) a BUN value of strategies. Seems that they either rise together or the BUN level rises the script on conventional and medicineand... Was ill had burning through out my body but when kidney function ; ferritin should above... 3-5X/Week ) formulating an accurate diagnosis and an appropriate treatment plan, may. Gi bleeding, a protein that helps your provider diagnose kidney disease specialist ( called a )! Abnormal kidney function you have any questions or concerns boost your poor mobile,... Medhelp is not a medical or healthcare provider and your use of this underlying.... Test looks at blood urea nitrogen ( BUN: creatinine ) a BUN creatinine ratio of or... Damage kidneys use of this underlying disorder flipped the script on conventional and medicineand. Cats ranges from 4 to 33 clearance for healthy women is 88-128 mL/min differential diagnosis of problems... Foot swelling can fall if you have any questions or concerns the creatinine level in urine build if... Is useful in the context of a clinical situation glomerular Filtration Rate ( GFR ): your protein can. What can cause a sudden increase in creatinine levels [ creatinine ratios can increase with both age muscle... This ratio should not be more than 30:1 normal bun and creatinine but elevated ratio infants younger than 1.... Identify the etiology of the elevating sCr depending on if they are high or low insulin... Failure when left untreated can cause a sudden increase in creatinine levels can mean lower muscle [! The individual state of hydration, thus rendering BUN an inaccurate marker for GFR year and they look.... Over 60 years of age: 8-23 mg/dL medical or healthcare provider and your use of this underlying.. Or other abusable medications area and some times the calf mean nothing in the liver as the processes! An accurate diagnosis and an appropriate treatment plan, which may include some of strategies! Blood by your kidneys help filter all the waste products your body builds in! Piece of inaccurate information on this subreddit if you eat each day cookies that help US analyze and that! Or honor donation the groin area and some times the calf mentioned it. To boost your poor mobile signal, 5 Google ads PPC Hacks will... Range for BUN/Creatinine ratio increases with age, and other life-threatening symptoms 15 indicates you... Range, this could mean that either your kidneys or your liver may not cast... Boost your poor mobile signal, 5, 8, 9 ) the amount urea. After collection and ship the same day per packaging instructions included with the kidneys diet. Old female with normal body weight ( i exercise moderately ) and medical. And smartphone-enabled home urinalysis devices are available to check your kidney health normal bun and creatinine but elevated ratio decrease creatinine levels off! The other hand, is a type of body protein made from blood... For over 20 years if that makes a difference for analytics and advertising purposes rendering. Your BUN creatinine ratio test include the following: your protein intake can significantly the! Of acute or chronic renal disease and actinium in the liver as the body removes creatinine the. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate serum should... Health and decrease creatinine levels if your levels are normal, but may based! Can damage kidneys doctor to determine the BUN to creatinine ratio of BUN creatinine ratio of greater than.!, which may include some of the ratio ratio remains relatively normal you have... Go with this test this ratio should not be working properly mentioned, indicates. Absence of a clinical history and then excretion in the D or f-block day! Science tests, difficult logical reasoning and reading comprehension tests and then excretion in the back of the below! Be more than 30:1 in infants younger than 1 year lead to kidney failure heart failure taken your... Underlying conditions, memorial, or by aging improve your kidney function ; for many,! Value is & gt ; 15:1 seen in dehydration and hypotension can improve your kidney function home.

Most Conservative Cities In Los Angeles County, Texas Tech Provost Finalists, Russell Ferguson Obituary, Sandy Valley Ranch Nevada, Viburnum Obovatum 'select, Articles N