Ketones in Urine

What are ketones in urine?

Ketones are metabolic product of fatty acids synthesized in liver. Normally the ketone production in body is very low to be found in urine. Lack of carbohydrates in the body causes excess breakdown of fatty acids for production of energy and that increase the ketone level in body and excrete through urine.

What does ketones in urine?

Moderate to high level of ketones in the urine is an indication of increased metabolism of fats in the body for maintaining the energy level in the body. Usually carbohydrates breakdown and produce sugar and in presence of insulin this sugar is taken up by cells to get fuel to maintain the normal physiological function inside the body tissues.

In absence of carbohydrates or insulin, the body do not get enough energy and utilizes stored fats in the muscles for production of energy and produce ketone bodies and residual is known as ketone. The excess production of ketone is poisonous for body and condition is known as ketonacidosis. Untreated Ketoacidosis is dangerous for health.

Image 1: Ketone in urine

Ketones in Urine Causes

The following are the conditions where ketones are found in urine:

• Type 1 and type 2 Diabetes, especially those who are having more than 300mg/dl blood glucose level.
• Pregnancy
• Low carbohydrates containing diet
• Excessive exercise
• Diarrheal condition
• Excessive vomiting
• Fasting for prolonged period
• Excessive alcohol consumption
• Illness due to infection

The entire above mentioned situations causes lack of carbohydrates that reach in cell to produce enough fuel to perform work, for that reason body utilizes fats for production of energy and leads to excessive ketones which found in urine.

Test Procedure

Ketone test for urine is an easy and convenient process for patient. The test is mainly conducted by using strips; these strips are available in the pharmacy for personal use, but need to produce prescription to get it.

In laboratory also this test is conducted. Different manufacture prepares these strips; the two most popular brands are Mission® Ketone and Ketostix®.

Image 2: Ketostix®  use for ketone test in urine

Before conduction of the test, it is suggested that the instruction of test procedure should be thoroughly followed and then conducted for obtaining the error free result. Urine test is one of the easiest estimation of ketone bodies and following instructions are required to follow:

• Check the expiry date of the package of the strips
• Take one clean sterilized urine collection container
• Collect the fresh urine into the container
• Take out a strip carefully
• Dip the strip into the urine sample
• Take out the strip
• Wait for the specific time written in the instruction note
• Notice the colour change
• Make a comparison between the colour changed in the strip and the colour chart provided on the strip bottle.
• Accordingly the value or range of the ketone in urine can be estimated by provided value with colour on the strip bottle.
• Maintain the documented result.

Normal Values

The absence of ketone in urine is referring as the normal value. The mild to severe range of ketone in urine level can be slightly differing from lab to lab result or may they choose different unit to explain the value of ketone in urine. It always advisable not to take the decision by own, consult with doctor to prevent any further clinical complications.

Clinical Significance

In normal condition ketone is not present in urine. The probability of findings which can link with presence of ketone in urine is utilization of fat in the body for production of energy instead of carbohydrates.

Uncontrolled diabetes of an individual causes high level of ketones in the urine due to defective carbohydrate metabolism.

Clinical significance of ketone test in urine provide the valuable monitoring tool for detecting the uncontrollable diabetes mellitus and give the indication for changing the insulin dose or insulin brand for the patient. It also helps to restrict the development of the ketoacidosis for diabetic patient and also stop the further complications which include diabetic coma.

In case of excessive exercise, fasting for prolonged time, rapid weight loss, and severe vomiting and diarrohea and electrolytes imbalance can cause mild to moderate level of ketone in urine.

References

1. Ketones urine test: How test performed at https://www.nlm.nih.gov/medlineplus/ency/article/003585.htm
2. Clinical Significance of Positive Urine Ketone Result at https://www.medialabinc.net/spg130944/clinical_significance_of_positive_urine_ketone_res.aspx
3. http://www.healthline.com/health/type-2-diabetes/facts-ketones#1
4. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-for-ketones.html?referrer=https://www.google.co.in/
5. What other tests might I have along with this test? at https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=ketone_bodies_urine