Lab Med Online.  2012 Jan;2(1):15-19. 10.3343/lmo.2012.2.1.3.

Evaluation of the Clinical Significance of Ketonuria

• Jung HW
• Park IK

• KMID: 1435747
• DOI: http://doi.org/10.3343/lmo.2012.2.1.3

Abstract

BACKGROUND
Urine ketone test is commonly used to screen for diabetic ketoacidosis (DKA). Ketonuria also develops in patients with disease conditions other than DKA. However, the prevalence of DKA in patients with ketonuria is not known. We investigated the prevalence of ketonuria and characteristics of patients with ketonuria and estimated the prevalence of DKA among them to study the clinical significance of ketonuria as an indicator of DKA.
METHODS
We studied 1,314 adult and 1,027 pediatric patients who underwent urinalysis. The prevalence of ketonuria in the different groups of patients, classified according to the types of their visits to the institution, was investigated, and the relationships between ketonuria and albuminuria, glycosuria, and bilirubinuria were evaluated.
RESULTS
The overall prevalence of ketonuria was 9.1%. The prevalences of ketonuria in adult and pediatric patients were 4.3% and 15.2%, respectively. The prevalences of ketonuria were the highest in the adult (9.7%) and pediatric (28%) patients in the group that had visited the emergency department. Among patients with ketonuria, 7% adult and 3.8% pediatric patients showed glycosuria.
CONCLUSIONS
This study showed that the prevalence of DKA in patients with ketonuria, defined as the simultaneous presence of ketone bodies and glucose in urine, was only 7%. Therefore, we concluded that ketonuria might be clinically significant as an indicator of acute or severe disease status rather than of DKA.

Keyword

Ketonuria; Urine ketone; Diabetic ketoacidosis

MeSH Terms

Adult
Albuminuria
Diabetic Ketoacidosis
Emergencies
Glucose
Glycosuria
Humans
Ketone Bodies
Ketosis
Prevalence
Urinalysis
Glucose
Ketone Bodies

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