The presence of ketones in urine indicates that the body is making use of fat as energy source instead of glucose. Ketonuria, as this condition is referred to, is characterized by the high quantity of ketone bodies in the urine. This arises when the body has to metabolize stored fat rather than glucose for fuel. Various factors could bring forth ketonuria including starvation, severe physical activity, prolonged exposure to cold, constant vomiting and diabetes.
What are the causes of ketones in urine?
Normally, the body gets energy from glucose. If, for some reason, there is not enough glucose that the body can use, it will switch to using stored fats. As fatty acids are metabolized, ketones will be produced by the liver. In a normal state, the amount of ketone that gets into the urine is minimal or nothing at all. But when the primary source of energy is stored fat, the quantity of unmetabolized ketones become significant it can be detected in the urine. This condition is known as ketonuria.
Ketonuria could be caused by a number of things. Some of these are:
When the body isn’t sufficiently nourished, there will be a shortage of carbohydrates to supply the body’s energy requirements. And so, stored fat will be processed in its place. Starvation could be a result of not eating for a long time, alcoholism, bulimia and anorexia. Fasting, high protein-low carbohydrate diets, severe vomiting and frequent diarrhea could likewise lead to starvation.
Uncontrolled diabetes milletus can cause high ketones in urine. In diabetes, the body is not able to break down glucose due to the lack of insulin. And so fat is metabolized to serve as fuel, instead.
- Other causes
Some other conditions could factor in the appearance of ketone bodies in the urine. These are long-term illnesses, fever, dehydration, hyperthyroidism and other disorders in which the metabolism is increased, glycogen storage disease, renal glycosuria, poisoning, alkalosis, pregnancy and lactation.
How is ketonuria diagnosed?
The presence of ketones in urine can be determined through a urine test. Before the test, any medications or drugs that could affect the test results must be stopped. In addition, a specialized diet may have to be recommended. Urine sample will be collected and placed in a sterile container. The detection of ketone bodies in urine is usually done as a “spot test”. A test strip specific for the identification of these bodies is dipped in the urine sample. The color will change depending on the level of ketone bodies in the urine.
Though standard normal values may differ from one laboratory to another, generally they follow the following with only slight variations.
- Small: less than 20 mg/dL
- Moderate: 30 – 40 mg/dL
- Large: greater than 80 mg/dL
There are instances when the results return false positives but no ketones are present. This may be attributed to certain medications like vitamin C, valporic acid, and levodopa.
What are the symptoms?
The level of ketones in the urine is an indicator of the status of the body. The symptoms that accompany ketonuria depend on the underlying cause. The following are some of the symptoms that usually accompany high amounts of ketones:
- breathing heavily
- dilated pupils
- frequent urination
- sweet smell of breath
What are the problems that may arise with high ketones in urine?
The accumulation of ketones in the body could lead to serious health problems especially for individuals with diabetes. If the condition is left unattended it could eventually result in ketoacidosis and hyperglycemia. The former is characterized by the presence of excessive ketones in the blood; whereas the latter is a condition in which the blood has high sugar levels.
How is ketonuria treated?
The presence of ketones in urine, especially if it is small, may be harmless. However, the cause must be determined first so that the appropriate treatment method can be applied. If it is found out that the condition is a result of starvation, diet modification to ensure that there will be sufficient source of carbohydrates will be recommended. For ketonuria resulting from insufficient level of insulin, the amount of insulin shot may need to be modified. Those with diabetes who test positive for ketones in urine must see their doctor so that management of the disease can be improved. On the other hand, increased ketone bodies in urine due to illnesses or metabolic disorders must be dealt with based on the underlying problem.
Can ketonuria be prevented?
High level of ketones in urine can be avoided by maintaining a well-balanced diet to ensure that the body has the right amount of energy source. Diabetics should also make sure that their disease is well under control. Insulin injection schedules must be followed religiously.