Ketone bodies in urine test

Your healthcare practitioner may advise you to undergo this test if you have diabetes. Excess ketones in body due to diabetes - diabetic ketoacidosis (DKA) - can be life-threatening, if not treated quickly. DKA more prominently occurs in individuals with type 1 diabetes than type 2 diabetes. Ketone bodies in urine test is used for the diagnosis of DKA.

You may need to undergo this test if you have diabetes and show the following symptoms:

• Feeling very thirsty
• Stomach ache
• Feeling tired or sleepy
• Desire to pee more than usual (Read more: Frequent urination causes)
• Feeling sick
• Deep/fast breathing
• Passing out
• Nausea and vomiting

You may also be asked to get this test if your blood glucose level is greater than 240 mg/dL.

If you have diabetes, the following conditions may alleviate ketone levels in your body:

• Missing doses of insulin
• Taking steroid-containing medications
• Using illegal drugs
• During periods
• Infections such as flu and urinary tract infections
• Injury or surgery
• Binge drinking
• Pregnancy

Apart from diabetes, the following conditions can cause ketoacidosis:

• Alcoholism
• Starvation
• Isopropanol ingestion
• Fasting
• High-protein diet
• Acute febrile illnesses (fever of 38°C or higher), especially in infants and children
• Pregnancy
• Extreme exercise
• Eating disorders 
• Chronic vomiting 
• Low carbohydrate diets

You may need to fast before this test. Tell your healthcare practitioner if you take any herbs, supplements, vitamins, medicines (including over-the-counter medications) or illicit drugs. The following drugs may lead to false-positive results:

• Isoniazid
• Phenazopyridine
• Phenolsulphonphthalein
• Bromosulphophthalein
• Levodopa
• Phenothiazines such as acetophenazine, triflupromazine and so on

A clean catch method is used to collect a urine sample for this test. You will be provided with a special container to collect the sample. Here is the right way for sample collection:

• Wash your hands properly.
• Clean your private parts. Women should open their labia and clean the area from front to back; men should wipe the tip of the penis.
• Let the first few drops of urine to flow out into the toilet bowl as you start urinating. Then, collect a midstream sample in the container - the container will have a mark to tell you how much sample is needed. In a mid-stream urine sample, you are not supposed to collect the first or last part of urine; since it reduces the possibility of contaminating the urine sample with bacteria from your hands or the urethra, a tube that carries urine out of your body.
• Close the container and wash your hands.

The test result may vary depending on your age, sex, diet, activity level, health history and other factors.

Normal results:

Normal test results are expressed as negative.

Abnormal results:

Abnormal results mean that you have high levels of ketones in your urine. It can be classified as follows:

• Small: <20 mg/dL
• Moderate: 30-40 mg/dL
• Large: >80 mg/dL

An abnormal result may indicate the following conditions:

• Diabetes mellitus
• Alcoholism
• Fasting
• High-protein diet
• Post-anaesthesia
• Starvation
• Anorexia, a mental illness in which a person does not eat/eats too less
• Vomiting
• Diarrhoea
• Fever
• Hyperthyroidism (overproduction of thyroid hormones)
• Pregnancy

The following conditions may affect the test results:

• Diets low in carbohydrates and high in fats and proteins
• Loss of ketones in the air when the urine sample stands for too long.
• Exercising strenuously

Discuss with your healthcare provider about what the test results mean for you.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.