Ketone bodies in urine

A high level of ketone bodies in urine indicates a marked increase in the metabolism of what ... 

Acetest and Ketostix are also suitable for detecting ketone bodies in urine. The sensitivity and specificity of the tests are the same as outlined for serum. 

A test which is used for the detection of ketone bodies in urine. It is based on the reaction of ferric chloride with acetoacetic acid to give a purple colour. 

Biochemical Ketone bodies in urine Little ketosis Little ketosis... 

In addition to these interconversions, the metabolism of fat and the metabolism of carbohydrate are inseparably related. This fact is most clearly demonstrated by the appearance of such abnormal products of fat oxidation as the so-called ketone bodies in the blood and urine whenever the supply of carbohydrate is deficient or in cases where the organism is unable to metabolize this foodstuff. Whether ketonuria results because the metabolism of fat must occur concomitantly with that of D-glucose (ketolysis), or whether the presence of D-glucose prevents any fat breakdown because it is preferentially oxidized (antiketogenesis) is still a moot question. 

In some poorly controlled diabetic patients the high rate of fatty acid oxidation decreases the mitochondrial NADVNADH concentration ratio so that the 3-hydroxybutyrate/acetoacetate concentration ratio can rise to as high as 15 in the blood. Since a test for ketone bodies in the urine (using Clinistix or similar material) detects only acetoacetate this can result in a serious underestimate of the concentration of ketone bodies in the urine. 

Ketonuria excessive amounts of ketone bodies in the urine Maculopapular eruptions skin condition characterised by a rash consisting of distinct eruptions Mania psychiatric disorder characterised by agitation and elated mood... 

If the production of ketone bodies exceeds the demand for them outside the liver, there is an increase in the concentration of ketone bodies in the plasma (ketonemia) and they are also eventually excreted in the urine (ketonu-ria). Both phenomena are observed after prolonged starvation and in inadequately treated diabetes mellitus. Severe ketonuria with ketoacidosis can cause electrolyte shifts and loss of consciousness, and is therefore life-threatening (ketoacidotic coma). 

Individuals on very low-calorie diets, using the fats stored in adipose tissue as their major energy source, also have increased levels of ketone bodies in their blood and urine. These levels must be monitored to avoid the dangers of acidosis and ketosis (ketoacidosis). ... 

Acetone is volatile and is exhaled, and in uncontrolled diabetes, the breath has a characteristic odor sometimes mistaken for ethanol. A diabetic individual who is experiencing mental confusion due to high blood glucose is occasionally misdiagnosed as intoxicated, an error that can be fatal. The overproduction of ketone bodies, called ketosis, results in greatly increased concentrations of ketone bodies in the blood (ketonentia) and urine (lcetonuria). 

Ition of the ketone bodies may be as high as 5000 mg/24 hr, and the blood concentration may reach 90 mg/dl (versus less than 3 mg/dL in normal individuals). A frequent symptom of diabetic ketoacidosis is a fruity odor on the breath which result from increased production of acetone. An elevation of the ketone body concentration in the blood results in acidemia. [Note The carboxyl group of a ketone body has a pKa about 4. Therefore, each ketone body loses a proton (H+) as it circulates in the blood, which lowers the pH of the body. Also, excretion of glucose and ketone bodies in the urine results in dehydration of the body. Therefore, the increased number of H+, circulating in a decreased volume of plasma, can cause severe acidosis (ketoacidosis)]. Ketoacidosis may also be seen in cases of fasting (see p. 327). 

According to a long-used classification amino acids are ketogenic if (like leucine) they are converted to acetyl-CoA (or acetyl-CoA and acetoacetate). When fed to a starved animal, ketogenic amino acids cause an increased concentration of acetoacetate and other ketone bodies in the blood and urine. On the other hand, glucogenic amino acids such as valine, when... 

Ketosis. A condition in which the concentration of ketone bodies in the blood or urine is unusually high. 

None of the commonly used methods for the detection and determination of ketone bodies in serum or urine reacts with ah three ketone bodies. Gerhardt s ferric chloride test reacts with acetoacetate only. Tests using nitroprusside are at least 10 times more sensitive to acetoacetate than to acetone, and give no reaction at all with P hydroxybutyrate. 

Ms. O Rexia is suffering from the consequences of prolonged and severe protein and caloric restriction. Fatty acids, released from adipose tissue by lipolysis, are being converted to ketone bodies in the liver, and the level of ketone bodies in the blood is extremely elevated (4,200 pM vs. normal of 70 pM). The fact that her kidneys are excreting ketone bodies is reflected in the moderately positive urine test for ketone bodies noted on admission. 

---