Lab

Urine Ketone

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Urine Ketone, Urine Ketone Test Strip

  • See Also
  1. Urinalysis
  2. Serum Ketone
  3. Ketone
  • Mechanism
  1. Urine Dipstick detects acetic acid (Acetoacetate)
    1. In Diabetic Ketoacidosis, Beta-Hydroxybutyrate (primary Ketone) is converted to Acetoacetate
  2. Confirmatory Test
    1. Urine
      1. Acetest tablet test
    2. Serum Ketone (preferred)
      1. Beta-Hydroxybutyrate
        1. Preferred Serum Ketone test
      2. Basic chemistry panel
        1. Ketoacidosis
          1. Low serum bicarbonate
          2. Increased Anion Gap
        2. Normal or resolving Ketoacidosis
          1. Normal serum bicarbonate
          2. Normal Anion Gap
  • Interpretation
  • Normal
  1. Negative
  • Causes
  • True Positive Urine Ketones
  1. Dehydration
  2. Starvation or Low Carbohydrate Diets (Ketogenic Diet)
  3. Diabetic Ketoacidosis (DKA)
  4. Alcoholic Ketoacidosis
  5. Isopropanol toxicity
  6. Pregnancy
  1. Low Urine pH (acidic)
  2. Increased Urine Specific Gravity
  3. Phenolphthalein
  4. Levodopa
  1. Delayed Urine Exam
  2. Not all Ketones (Beta-Hydroxybutyrate, Acetoacetate, Acetone) are detected by all Urine Dipstick tests
    1. Most Urine Dipsticks detect Acetoacetate
  • References
  1. Hitzeman (2022) Am Fam Physician 106(1): 27-35 [PubMed]
  2. Simerville (2005) Am Fam Physician 71(6): 1153-62 [PubMed]