Urine Ketones

A ketone test can warn you of a serious diabetes complication called diabetic ketoacidosis, or DKA. An elevated level of this substance in your blood can mean you have very high blood sugar. … Regular tests you take at home can spot when your ketone levels run too high.

A urinalysis is a test of your urine. A urinalysis is used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes.

A urinalysis involves checking the appearance, concentration and content of urine. Abnormal urinalysis results may point to a disease or illness.

Also Known as:  Urine Test, Urine Analysis , Urine CE, Urine C/E, UCE, Urinalysis

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Test Panel: Physical properties, Chemical Tests, Dipstick Tests, Microscopic Examination

Type of urine samples:

• Random sample:
  This is a diluted urine sample and may give an inaccurate interpretation of patient health. But is best to do microscopy to evaluate WBC or RBC.
• First Morning sample:
  This is the best sample for microscopy and urine analysis. This is the concentrated urine because of urine remained throughout the night in the urinary bladder. This will contains an increased concentration of analytes and cellular elements. Urine must have remained in the bladder for 8 hours is considered as the first-morning sample.
• Urine for sugar (Postprandial 2 hours):
  Postprandial 2 hours sample collected after 2 hours of high carbohydrate diet. 
• Midstream clean catch urine:
  This sample is needed for the culture and sensitivity of urinary infection. The patient is advised to clean the urethra, then discard the first few mL of urine. Now midstream of the urine is collected in the sterile container.
• 24 Hours of a urine sample
  • In this case, discard the first urine and note the time.
  • Now collect urine in the container for 24 hours and put the last sample in the container.
  • Refrigerate the sample.
  • This 24 hours samples are needed for measuring urea, creatinine, sodium, potassium, glucose, and catecholamines.
• Suprapubic collection of the urine sample:
  This is done in the patients who cannot be catheterized and the sample is needed for culture. This sample is collected by the needle.
• Catheter collection of urine:
  This is done by patients who are bedridden and can not urinate.
• Pediatric urine sample:
  In infants, special collection bags are made adherent around the urethra. Then urine is transferred to a container.

Urinary Ketones

The test measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don’t get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. A ketones in urine test can prompt you to get treatment before a medical emergency occurs.

Why Get Tested:

The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don’t have diabetes, you may still be at risk for developing ketones if you:

• Experience chronic vomiting and/or diarrhea
• Have a digestive disorder
• Participate in strenuous exercise
• Are on a very low-carbohydrate diet
• Have an eating disorder
• Are pregnant

When to get Tested:

Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:

• Nausea or vomiting
• Abdominal pain
• Confusion
• Trouble breathing
• Feeling extremely sleepy

People with type 1 diabetes are at a higher risk for ketoacidosis.

Sample Required:

• The is done in the urine (Random Sample).

Normal Range:

• Ketone bodies are negative.
• Small amount = < 20 mg/dL.
• Moderate amount = 30 to 40 mg/dL.
• Large amount = > 80 mg /dL.

It is reported as:

1. Negative.
2. Moderate.
3. Large amount  OR as (1+, 2+, 3+)

Ketone bodies are seen in:

1. Diabetic patients.
2. Starvation.
3. Fasting.
4. High protein diet.
5. Alcoholism.
6. salicylates poisoning.
7. Isopropanol intake.
8. Acute febrile illness (especially in infants and children).
9. Renal Glycosuria.
10. Glycogen storage disease (Von Gierke’s disease).
11. Anorexia.
12. Low carbohydrate diet.
13. Pregnancy or lactation.
14. Eclampsia.

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