What is the presence of ketone bodies or acetone in the urine

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Ketone bodies or ketones are organic compounds produced by the liver. These include acetone, acetoacetic and beta-hydroxybutyric acid. The excessive formation of these substances causes their accumulation in the blood and penetration into the urine. Such a condition in medicine is called ketonuria or acetonuria, and in people - acetone in urine. What this means and how serious the problem is is to help determine the doctor with the help of a group of analyzes.








  • The human body derives its energy from glucose, which accumulates in the liver as a specific substance called glycogen. If glycogen stores are not enough, the energy is extracted from fats, the cleavage of which generates ketone bodies. They are quickly excreted in the urine, and due to the low concentration they are practically not determined by laboratory methods. Normally, the amount of acetone excreted in the urine is 20-50 milligrams per day.


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    Detection of ketone bodies can be done using a general urine test. For the study, you need an average dose of morning urine placed in a sterile container. The results are deciphered as follows:

    • Negative reaction - the amount of ketones does not exceed 0.5 millimoles( or 5 milligrams) per 1 liter of urine.
    • Weakly positive( +) - not more than 1.5 millimoles( 15 milligrams) per liter of urine.
    • Positive( ++ or +++) - the acetone concentration is 1.5-4 millimoles( 15-40 milligrams) per liter.
    • Sharply positive( ++++) - the level of ketone bodies reaches 10 millimoles( 100 milligrams) per liter of urine.

    You can also use test strips to determine the concentration of ketone bodies, which should be dipped in the collected urine. When acetone enters the indicator zone with the reagent applied, it stains, after which the result can be compared with a special color scale. Convenience of such analysis is that it can be quickly carried out at home.

    If the ketone concentration is slightly elevated, there is a slight abnormality that does not require treatment. With a significant increase in the level of acetone in urine, it is necessary to find out the cause of the pathology and determine the actions to eliminate it.

    The norm of the content of ketone bodies in the child's urine is from 0 to 0.4 millimole( 0-4 milligrams) per 1 liter.

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    Causes of

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    In adults

    Ketonuria is a consequence of a violation of fat and carbohydrate metabolism in the body, the causes of which may be:

    • Increased energy consumption due to excessive physical, mental, emotional stress.
    • Incorrect food with a lot of protein food and a lack of carbohydrates.
    • The use of products containing ketogenic amino acids - phenylalanine, tyrosine, isoleucine, leucine.
    • Dehydration of the body. Can occur in diseases with fever, diets or fasting, poisoning with severe vomiting or diarrhea.
    • Insufficiency of the enzymatic function of the liver and pancreas, which leads to disruption of metabolism and the accumulation of ketones in the blood and urine. Diabetes mellitus in decompensation stage. Usually, together with acetone in urine, an increased level of glucose is detected.
    • Alcoholic ketoacidosis - with accumulation of ketones in the blood because of the constant use of alcohol, the body tries to remove them with urine.
    • Oncological lesions and inflammations of the gastrointestinal tract, intestinal infections entail a violation of absorption of nutrients, which negatively affects the metabolic processes in the body.
    • Tumors of the adrenal and thyroid gland - an increased level of hormones, corticosteroids, accelerates the metabolism of fats and the process of the formation of glucose from them.
    • Thyrotoxicosis - an excess of thyroid hormones contributes to rapid consumption of carbohydrates from the blood.
    • Development of stenosis of the esophagus - a decrease in the diameter of its lumen, disrupting the normal patency of food.
    • Recovery period after general anesthesia.

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    During pregnancy

    Periodic detection of traces of ketones in the urine of a pregnant woman is not a pathology and can be caused by an increase in body load or toxicosis of the first half of pregnancy, which is accompanied by frequent vomiting.

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    In this case, the doctor can advise to minimize activity, to comply with drinking regimen, to adjust the diet. The food should be fractional and frequent, it is also necessary to increase fluid intake, preferably in the form of solutions of electrolytes.

    The appearance of acetone in urine at late stages, especially in the third trimester, may indicate gestosis - a serious complication of pregnancy, requiring increased attention from doctors.

    Read also what beverages and products can be consumed for various types of poisoning accompanied by vomiting http://woman-l.ru/chto-mozhno-est-posle-pishhevogo-ili-drugogo-vida-otravleniya/
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    In a child,

    Glycogen reserves in children are much lower than in adults, so fat splitting to obtain energy begins with a much lower energy loss, which often reveals acetonuria when analyzing urine. Usually this phenomenon is observed in children 1-12 years old, it can be provoked by a violation of the absorption of carbohydrates and fats, viral infections, physical activity, emotional stress, stress, strong emotions( even positive ones).

    In neonates, an increase in ketone bodies in the urine is almost always caused by inadequate feeding. There is also a rare( 1 in 120-300 thousand children) hereditary disease - leucinosis or branched-chain ketonuria - in which the metabolism is broken, there is a depression of the nervous system, development retardation, ketone bodies are found in the blood, and the smell of urine resembles a maple syrup. This disease is very difficult and often ends lethal.

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    Ketonuria in children can be either permanent or single. In the latter case, it is often accompanied by acetonemic vomiting, a feature of which is the previous odor of acetone from the oral cavity, from the urine, and then from the vomit.

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    Treatment of

    To reduce the level of ketone bodies in urine, it is necessary to find out the root cause of this condition and eliminate it:

    • Normalize and balance power. The diet should contain digestible carbohydrates and a minimum amount of fat.
    • Optimize the load, both physical( in bodybuilding and sports), and psychological( during exams, with a high workload at work), eliminate stress.
    • Observe the regime of the day and rest( walks, healthy sleep, regular tireless exercise).
    • Identify possible diseases and cure or control them.
    • For patients with diabetes, acetone in the urine means the progression of the disease and requires an adjustment of the level of insulin.
    • People prone to ketonuria, need to do a cleansing enema at least once a week.
    Ignoring the problem can cause an acetonemic crisis, when an elevated level of acetone causes fever, abdominal pain, and vomiting. In this condition, many patients require hospitalization and intravenous fluids.

    The main objectives of the treatment are:

    • Replenishment of trace elements - for this use solutions of electrolytes( Regidron, Human Electrolyte) orally or in the form of enema, mineral water( Borjomi, Luzhanskaya).
    • Elimination of dehydration after vomiting - it is desirable by soldering several sips of liquid every 5-10 minutes. In addition to the above solutions and water, it can also be compotes of dried fruits, sweet fruit juices, sweet tea with lemon.
    • Coping the toxic effect of ketone bodies on the body - cleansing of the bowel enema, the use of enterosorbents( Smecta, Fosfalugel, Enterosgel).

    Tightening with ketonuria treatment can lead to death.

    • Mar 06, 2018
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