To provide a person and all his organs with energy, the body breaks down glycogen and produces glucose. For the work of the brain, this is the main energy supplier. Unfortunately, glycogen stores are very limited. When they end, the body switches to other energy sources - ketones. In the urine and blood of a healthy person, there are practically none. The identification of these substances in the analysis indicates an existing pathology.
What are ketones?
The name "ketone" comes from the German "acetone". Ketones are substances whose molecules have an organic compound of oxygen with hydrogen and two hydrocarbon radicals. There are many varieties of ketones. For example, ubiquinone, it is extremely important for the work of the heart. They contain the ketone group known to all fructose, menton, which is part of the oral care products, carvone used in the food industry, progesterone, cortisone, even tetracycline. Each of us has ketones in urine and blood, daily excreting approximately in the amount of 20-50 mg, of which 70% falls on weak beta-hydroxybutyric acid, 36% on stronger acetoacetic acid and 4% on acetone. The last element is least of all, because it can be excreted from the body during breathing. Such a scanty sample of Lange, Legal and others do not show. That is why it is believed that in a healthy person the norm of ketones in the urine is their complete absence.
Ketonuria and Ketoacidosis
In medicine, several conditions associated with ketones are distinguished. When there are a lot of them in the blood, they talk about ketonemia, and in the urine - about ketonuria. With a sufficiently high content of ketone bodies , PH begins to be disturbed and ketoacidosis develops. If there are a lot of ketones, but the electrolyte changes in the blood have not yet begun, they say ketosis. Ketonuria is observed in people with impaired protein, fat or carbohydrate metabolic processes. This condition often occurs in young children and pregnant women.
There are a number of factors in which ketone is found in urine. The reasons are as follows:
- diabetes;
- pancreatitis;
- alcohol intoxication ;
- head injuries;
- hemorrhages;
- operations on the shells of the brain;
- strong excitement of the nervous system;
- multiple muscle injuries;
- severe infectious diseases;
- glycogen disorders in the body;
- thyrotoxicosis;
- excessive physical activity;
- dysentery;
- frostbite;
- febrile conditions;
- intoxication;
- improper nutrition (multi-day hunger strike).
Ketones in the urine of a child
In children under the age of 13 years, but more often up to 10 years, ketones can be excreted in urine in large quantities. If it is not associated with diabetes, the cause is a violation of the acid-base balance. Symptoms
- strong smell of acetone from the mouth ;
- nausea;
- weakness, sometimes to fainting;
- headache (occurs abruptly);
- copious vomiting;
- general weakness;
- sometimes there are pains in the stomach.
During attacks, it is recommended to give "Stimol", "Citrargenin", a sweet drink (tea, juice, water with syrup). The nutrition of such children should be strictly dietary, excluding fatty foods, muffins, especially with chocolate additives, sour fruits and vegetables, carbonated drinks. When the attack passes, the baby's condition becomes more or less stable. Improper nutrition, starvation, nervous stress in babies, and some infectious diseases can cause childhood non-diabetic ketonuria.
Ketonuria in pregnant women
Ketones in the urine during pregnancy can be precursors of early toxicosis, as well as a specific disease called gestational diabetes, which occurs only in pregnant women. It occurs when there is a violation of carbohydrate metabolism in the body of the expectant mother and is very often found only in laboratory tests. The woman herself may not feel any pathological changes. However, this disease, which in most cases occurs after childbirth, can be a harbinger of ordinary diabetes mellitus, as well as endocrine pathologies. If the analysis showed ketones in the urine, a pregnant woman should undergo additional tests to exclude the presence of true diabetes and thyroid diseases. It is also important to establish the right balanced diet, sparing daily routine, and completely eliminate the use of alcoholic beverages, toxic and harmful substances.
Ketonuria in diabetes
In insulin-dependent people, ketones in urine are present daily in an amount up to 50 g. This condition should be changed in the direction of a significant decrease very quickly, in no more than 2 days. This is achieved by regulating insulin doses. Urine for research should be taken every 4 hours. The manifestation of ketonuria in babies with diabetes is especially dangerous. For about 10% of them, it ends in death. Most often, ketonuria is observed in patients with type I diabetes, that is, insulin-dependent. In all other diabetics, an increase in ketones occurs for the following reasons:
- insufficient doses of insulin;
- missed injections or poor-quality insulin (expired);
- Infectious and colds (sinusitis, pneumonia, meningitis and others);
- thyroid problems and related disorders;
- heart attack, stroke;
- injuries, operations;
- stresses;
- taking hormonal contraceptives.
Ketones, diabetes and pregnancy
An indispensable indicator of the presence of diabetes is the detection of glucose along with ketones in the urine. If these two substances are found in the first trimester, there is a high probability that the woman has true diabetes, which existed before pregnancy. This condition is very unfavorable for both the expectant mother and the developing fetus. It threatens a woman with polyhydramnios, complicated births, vascular diseases, hypoglycemia, fetal freezing, termination of pregnancy, early and late gestosis, severe toxicosis. A baby can be born with various abnormalities. Inheritance of the disease is observed in 1.3% of children, if an insulin-dependent mother, and in 6.1% - if a father is sick. If ketones are found in the urine during pregnancy, and the diagnosis of ordinary diabetes is confirmed, the expectant mother must necessarily undergo the therapy prescribed by the doctor and go on a strict diet.
Diagnostic Methods
Determination of ketones in the urine can be carried out laboratory and at home. The legal test is generally available. For its implementation, a special strip saturated with an alkaline substance and sodium nitroprusside is placed in urine for 1 minute. The properties of the impregnating solutions are such that if there is an increased proportion of ketones in the urine, they change color from white to brown-red. The brighter the color, the more ketones are contained. Their number, this test shows only approximately. For more accurate numbers, a blood test is taken. But in the Legal test there is a huge advantage - it can be performed independently countless times. Assign it to diabetics, pregnant women, children with acetonemic syndrome. When treating with sulfhydryl group preparations (Captopril, Capoten and others), the test does not justify itself and may give a false result.
Treatment and prevention
Ketosis can be treated at home. The main event for the patient is a strict diet. Of the drugs prescribed drugs "Cocarboxylase", "Essential", "Splenin", "Methionine". So that ketones in the urine do not increase, it is forbidden to use the following products:
- soup or borscht on bone, fish, mushroom broth;
- offal;
- smoked meats;
- pickles, marinades;
- river fish (except for pike and pike perch);
- crayfish;
- fatty foods, including cottage cheese and cheese;
- sour apples, citrus fruits, cherries;
- some vegetables (tomatoes, peppers, eggplant, sorrel, spinach, rhubarb);
- mushrooms;
- sauces (mayonnaise, ketchup, adjika);
- cream cakes, chocolate, muffin;
- coffee, carbonated drinks, black tea.
Products to be limited:
- canned meat;
- seafood;
- herring;
- bean;
- pasta;
- cupcakes, biscuits;
- some fruits (bananas, kiwi);
- sour cream.
With progressive ketosis and ketoacidosis, treatment is carried out inpatiently. Prevention of these conditions consists in proper nutrition and a sparing regime of the day, and for patients with diabetes, in the timeliness of insulin injections and regular monitoring of ketones in the urine.