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Ketonuria (ketone bodies in the urine)

Ketonuria (ketone bodies in the urine)

Ketonuria is the detection of ketone bodies in the urine. Ketone bodies - acetone, acetoacetic acid, and beta-hydroxybutyric acid, occur together in the urine. Normally, 20-50 mg of ketone bodies per day are excreted in the urine, which is not detected by ordinary high-quality tests.

Ketone bodies appear in urine when the metabolism of carbohydrates, fats, and proteins is disturbed, which is accompanied by an increase in ketogenesis in tissues and the accumulation of ketone bodies in the blood (ketonemia).

Ketonemia can also occur with:

  • unbalanced diet
  • pregnancy
  • starvation
  • fever
  • alcohol intoxication
  • poisoning
  • infectious diseases (scarlet fever, flu, tuberculous meningitis)

In the urine, ketone bodies appear with ketonemia. Ketonuria in the postoperative period is explained by protein breakdown due to surgical trauma.

In adults, ketonuria is more common in severe diabetes. Ketonuria in diabetes develops due to increased ketogenesis and ketolysis disorders. Increased mobilization of fats from adipose tissue, decreased formation of oxalacetate in the Krebs cycle, and decreased biosynthesis of fatty acids lead to enhanced ketogenesis.

In severe diabetes, accompanied by damage to the kidney tissue (the site of cleavage of ketones), an additional impaired ketolysis occurs.