Ketones in urine are causes. Ketones in the urine during pregnancy

To ensure a person and all his organs with energy, the body breaks down glycogen and produces glucose. For the work of the brain it is the main energy supplier. Unfortunately, the reserves of glycogen are very limited. When they end, the body switches to other sources of energy - 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 oxygen compound 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 ketone group all known fructose, menton, which is part of oral care products, carvone used in the food industry, progesterone, cortisone, even tetracycline. Each of us has ketones in urine and blood, daily standing out in approximately 20-50 mg, of which 70% is for weak beta-hydroxybutyric acid, 36% for a stronger acid acetoacetic and 4% for acetone. The last element is least of all, because it can be excreted from the body by breathing. Such a scanty amount of sample Lange, Legal and others do not show. That is why it is considered that in a healthy person the norm of ketones in urine is their complete absence.

Ketonuria and ketoacidosis

In medicine, several conditions are associated with ketones. When there are a lot of them in the blood, they talk about ketonemia, and in the urine - about ketonuria. At a sufficiently high content of ketone bodies , PH starts to break and ketoacidosis develops. If there are many ketones, but in the blood so far electrolyte changes have not begun, talk about 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 a ketone is found in the urine. The reasons are as follows:

- diabetes;

- pancreatitis;

- alcoholic intoxication ;

- craniocerebral trauma;

- hemorrhage;

- operations on the membranes of the brain;

- strong excitation of the nervous system;

- multiple injuries of muscles;

- severe infectious diseases;

- glycogen disorders in the body;

- thyrotoxicosis;

- Excessive physical activity;

- dysentery;

- frostbite;

- feverish conditions;

- intoxication;

- malnutrition (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 the urine in large quantities. If this is not related to diabetes mellitus, the cause is a violation of the acid-base balance. Symptoms:

- strong odor of acetone from the mouth ;

- nausea;

- weakness, sometimes to fainting states;

- headache (occurs abruptly);

- profuse vomiting;

- general weakness;

- Sometimes there are pains in the stomach.

During the attacks it is recommended to give "Stimol", "Citrgenin", sweet drink (tea, juice, water with syrup). The nutrition of these children should be strictly dietary, excluding fatty foods, baking, especially with chocolate additives, sour fruits and vegetables, carbonated drinks. When the attack passes, the condition of the baby becomes more or less stable. To cause a child's non-diabetic ketonuria may be malnutrition, starvation, nervous stress in toddlers, and some infectious diseases.

Ketonuria in pregnant women

Ketones in the urine during pregnancy can become harbingers of early toxicosis, as well as a specific disease called gestational diabetes, found only in pregnant women. It occurs when there is a violation of carbohydrate metabolism in the body of a future mother and is very often found only in laboratory tests. The woman herself can not feel any pathological changes. However, this disease, which in most cases passes after childbirth, can act as a harbinger of normal diabetes mellitus, as well as endocrine pathologies. If the analysis showed ketones in urine, the pregnant woman should undergo additional tests to exclude the presence of true diabetes and thyroid disease. It is also very important to establish the right balanced diet, gentle mode of the day, completely eliminate the use of alcoholic beverages, toxic and harmful substances.

Ketonuria in diabetes mellitus

In insulin-dependent people ketones in the urine are present daily in an amount up to 50 g. Such a state should be changed toward a significant reduction very quickly, no more than 2 days. This is achieved by regulating the doses of insulin. Urine for research should be taken every 4 hours. Especially dangerous is the manifestation of ketonuria in children with diabetes mellitus. Approximately 10% of them end in a lethal outcome. Most often ketonuria is observed in patients with type I diabetes, that is, insulin-dependent. In all other diabetics, ketones increase for the following reasons:

Insufficient doses of insulin;

- missed injections or poor-quality insulin (overdue);

- infectious and catarrhal diseases (sinusitis, pneumonia, meningitis and others);

- Thyroid problems and related disorders;

- heart attack, stroke;

- traumas, operations;

- stress;

- taking hormonal contraceptives.

Ketones, diabetes and pregnancy

An undeniable 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 large share of the likelihood that a woman has a true diabetes that existed before pregnancy. This condition is very unfavorable for both the future mother and the developing fetus. It threatens women with polyhydramnios complicated by birth, vascular diseases, hypoglycemia, fetal fading, abortion, early and late gestosis, and toxicosis in severe form. A child can be born with various anomalies. Inheritance of the disease is observed in 1.3% of children, if the insulin-dependent mother, and in 6.1% - if the father is sick. If ketones are found in the urine during pregnancy, and the diagnosis of normal diabetes mellitus is confirmed, the expectant mother must necessarily undergo the therapy prescribed by the doctor and sit on a strict diet.

Methods of diagnosis

The determination of ketones in urine can be carried out laboratory and at home. The Legal test is widely available. For its implementation, a special strip, impregnated with alkaline substance and sodium nitroprusside, is placed in the urine for 1 minute. The properties of impregnating solutions are such that when there is an increased proportion of ketones in the urine, they change color from white to brownish-red. The brighter the color, the more ketones are contained. Their number shows this test only approximately. For more accurate figures, a blood test is taken. But in Legal's test there is a huge advantage - it can be performed independently many times. Assign it to diabetics, pregnant women, children with acetone syndrome. When treating drugs sulfhydryl group ("Captopril", "Kapoten" and others), the test does not justify itself and can give a false result.

Treatment and prevention

Ketosis can be treated at home. The main activity for the patient is a strict diet. From drugs prescribe the funds "Cocarboxylase", "Essentiale", "Splenin", "Methionine". To ketones in the urine did not increase, it is forbidden to eat the following foods:

- soup or borsch on bone, fish, mushroom broth;

- by-products;

- Smoked meat;

- pickles, marinades;

- river fish (except pike and pike perch);

- crabs;

- fatty foods, including cottage cheese and cheese;

- sour apples, citrus fruits, cherries;

- Some vegetables (tomatoes, peppers, eggplants, sorrel, spinach, rhubarb);

- mushrooms;

- sauces (mayonnaise, ketchup, adjika);

- cakes with cream, chocolate, baking;

- coffee, carbonated drinks, black tea.

Products to be restricted:

- canned meat;

- seafood;

- herring;

- beans;

- pasta;

- muffins, biscuits;

- some fruits (bananas, kiwis);

- sour cream.

With progressive ketosis and ketoacidosis treatment is carried out permanently. Prevention of these conditions is the proper nutrition and gentle mode of the day, and for diabetics - in timeliness of insulin injections and regular monitoring of ketones in the urine.