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ketone bodies in urine

also see ketone bodies in serum/plasma/urine Indications: 1) assessment of diabetic ketoacidosis 2) verification of compliance with weight-reducing regimen Normal range: - urine: negative, limit of detection 5-10 mg/dL (0.5-1.0 mmol/L) Increases: 1) chemical interferences a) urine (in vitro) -> acetylcysteine, captopril, cysteine, dimercaprol (BAL), 8-hydroxyquinoline (preservative), levodopa, MESNA (2-mercaptoethane sulfonate), D-penicillamine, phenazo- pyridine, phenolphthalein, phenylketones b) urine (in vivo) -> aspirin intoxication, ethanol, ether anesthesia, inositol, isopropanol, metformin, methionine, nicotinic acid, phenformin, valproic acid c) hemolysis causes discoloration of test tablets or sticks 2) clinical disorders a) diabetic ketoacidosis*, prolonged fasting, severe carbohydrate restriction with normal fat intake (weight- reducing diets), anorexia nervosa, persistent vomiting, glycogen storage diseases, branched chain ketonuria, methylmalonic aciduria, exercise in untrained subjects, pregnancy, stress, post-anesthesia b) states with markedly increased metabolic rates -> high fever, severe thyrotoxicosis, active acromegaly c) excessive hormone production/administration -> growth hormone, ACTH, glucocorticoids, hyperinsulinism, catecholamines * In some cases of diabetes mellitus with elevated blood ketone levels, no ketone bodies appear in the urine. Method: - reagent strip: nitroprusside (Miles Inc. Acetotest, Ketostix, Labstix, Multistix, BMC Chemstrip) - beta-hydroxybutyrate is NOT measured - acetone is measured by Chemstrip & Acetest - False positives (urine): a) highly pigmented urine b) specimens with 8-hydroxquinoline as a preservative Specimen: - urine

Related

beta(3)-hydroxybutyrate in blood/plasma/serum

General

ketone bodies in body fluid urine chemistry test

References

  1. Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
  2. Panel of 22 tests Laboratory Test Directory ARUP: 20350