In recent years, laboratory technicians are increasingly finding acetone in the urine of adults or children. Should he be there? What are the reasons for this change in urine composition? Readers will find answers to these and other questions in the proposed article.
A phenomenon in which an elevated content of so-called ketone bodies is noted in the urine, doctors call acetonuria or ketonuria. Ketone bodies are products formed during the incomplete oxidation of proteins (proteins) and fats (lipids) in the body. Specifically, it is acetone itself, acetoacetic and hydroxybutyric acids. Acetone may be present in human urine of any age. The main thing is that its concentration in the norm should be insignificant (from twenty to fifty milligrams per day). From the body, it is continuously excreted by the kidneys. But if the amount of acetone exceeds the permissible norms, then it is urgent to take measures for the signal that the body sends.
Signs that “signal” that excess acetone is present in the urine:
characteristic odor during urination
the smell of acetone coming from the mouth
In children, the symptoms may be different:
refusal of food
smell of acetone emanating from urine, vomit, from the mouth,
pain in the navel,
vomiting after eating or taking any liquid,
irritability, quickly replaced by drowsiness and lethargy.
The reasons for the appearance of "excess" acetone in the urine
In adults, such an unpleasant phenomenon can occur in the following cases:
- If everyday foods are dominated by foods with a lot of fats and proteins, when the body is unable to break them all down. If the diet is not enough food rich in carbohydrates.
- The situation can be corrected even without drugs, by balancing food, introducing carbohydrates into the daily menu.
- Another reason is excessive exercise or heavy physical activity. Then, in order to straighten the analyzes, it is necessary to adjust the level of load that the body can afford.
- Third - prolonged fasting, "sitting" on a rigid diet. To restore health, you need the help of a nutritionist, the rejection of starvation.
- Fourth - deterioration of the pancreas, type 1 diabetes mellitus, or type 2 diabetes mellitus, developing for many years. It is clear that such people do not have enough carbohydrates for the complete oxidation of lipid and protein products. This situation is already more serious, it is dangerous because there is a chance of a diabetic coma.
More acetone in the urine may increase with:
- hypoglycemia attacks, which are provoked by an increased level of insulin in the blood,
- high temperature
- infectious diseases (scarlet fever, flu, meningitis),
- after some types of anesthesia,
- alcohol intoxication,
- cerebral coma
- precomatous condition
- severe depletion of the body,
- severe anemia
- stenosis (narrowing) of the esophagus, cancer of the stomach,
- indomitable vomiting of pregnant women,
- severe toxicosis, which develops in some women in the late stages of gestation,
- after injuries leading to damage to the central nervous system.
In childhood, acetone in the urine appears due to malfunctioning of the pancreas. If the pancreas does not cope with its work, then it produces an insufficient amount of enzymes.
Reasons for the development of childhood ketonuria (acetonuria):
- overeating, errors in nutrition, the presence of preservatives, dyes, synthetic flavors in the composition of products,
- stresses, increased excitability of the baby,
- fatigue, overwork,
- uncontrolled intake of drugs from the antibiotic group,
- high temperature rise
- dysentery, the presence of helminthic infestations, diathesis.
- The treatment of ketonuria directly depends on the causes of acetone in the urine and the severity of the process.
- Sometimes it’s enough just to balance the diet, make changes to the daily menu.
- If acetone is very high, then the patient is sent to a hospital.
- Therapeutic tactics depend on what causes the appearance of acetone in the urine. If the causes are eliminated, then the analyzes will improve.
So, it all starts with a strict diet and drinking plenty of water. It is taken a little, but often. Children are given every five minutes a teaspoon (which is 5 ml). Ready-made solutions purchased in a pharmacy, for example, Regidron, Orsol, are useful. It is allowed to drink mineral water (without gas), a decoction of raisins or other dried fruits, an infusion of chamomile.
If the patient has severe vomiting, then the doctor prescribes the introduction of solutions through an intravenous dropper. Metoclopramide (Cerucal) is used to relieve vomiting.
In some cases, to improve the condition of the liver, Essentiale, Methionine, milk thistle meal are prescribed.
To accelerate the elimination of toxins, “White” coal, Sorbex, Activated carbon, Polyphepan, Polysorb, Enterosgel are used.
A bit about nutrition
As PoMedicine has already noted, with the appearance of acetone in the urine It is important to follow a certain diet. It is useful to eat various vegetable soups, cereals, fish dishes (low-fat). It is allowed to eat little meat of turkey, rabbit, beef, veal. It is advisable to cook meat, stew or bake in the oven.
Restore the water balance, replenish the body with vitamins help fruits, vegetables, juices (freshly squeezed), fruit drinks, berry fruit drinks.
It is worth refusing from fatty meat, canned food, fried foods, smoked meats, cocoa, coffee, spices, mushrooms, all kinds of sweets, as well as bananas, citrus fruits.
If urination is felt smell of acetone, then this indicates that some problems have occurred in the body. If the doctor correctly identified the cause that caused the increase in ketone elements in the urine, he will prescribe an effective treatment and indicate what changes should be made to the diet.
Causes of a substance in urine
A relevant issue at many thematic forums among patients remains what it means if acetone is detected in the urine.
Normally, the content of the substance should be no more than 0.5 mmol / L.
Exceeding the normal value can be the result of many diseases or conditions. Acetonuria occurs in adulthood and childhood.
An increase in the level of acetone in the urine in adults, both men and women, can be triggered by a number of reasons:
- Bad eating habits. Deficiency in the diet of carbohydrates, the predominance of proteins and lipids leads to a violation of metabolic processes. It is also important not to consume foods that cause allergies. For this, a blood test is carried out, which determines food intolerance.
- Physical activity. Sometimes exhausting exercises can lead to acetonuria. Then adjustment of physical activity is required.
- Prolonged fasting and a tough diet. In such cases, you will have to turn to a nutritionist for help and develop an optimal diet.
- Diabetes. Acetonuria may be due to pancreatic depletion in non-insulin-dependent diabetes or insulin-dependent diabetes.
- Thyrotoxicosis. With an increase in the level of thyroid hormones, an increase in ketone bodies can occur.
- Hyperinsulinism. An increase in insulin concentration leads to a sharp decrease in blood glucose (hypoglycemia), which leads to acetonuria.
- Digestive system diseases. These include stenosis of the pylorus of the esophagus or stomach, the presence of cancerous tumors.
- Other reasons - alcohol intoxication, cerebral coma, hyperthermia, toxicosis during pregnancy, anesthesia, central nervous system injuries, infectious pathologies, anemia, cachexia, poisoning with heavy metals and chemical compounds.
In preschool and adolescence, the disease develops under the influence of such factors:
- errors in nutrition,
- strong physical activity,
- stressful situations,
- helminthic infestations,
- dysentery and diathesis,
- taking antibiotics.
During pregnancy, the presence of acetone in the urine may be associated with a psychoemotional state, the negative effects of negative external factors, toxicosis, decreased immunity, or the consumption of foods with dyes, chemicals, preservatives, etc.
Video: Acetone in urine: causes, symptoms, treatment, diets
In detail about acetonuria
The first step is to focus on the features and characteristics of ketone bodies - this will help a more complete understanding of the dangers of acetonuria. It will also explain why a severe degree of this deviation requires immediate medical attention. The most commonly used synonym for ketones, especially among physicians (even equates to professional jargon (slang)), is acetone. This word takes its roots from the Latin "acetum", which translates as acid.
Historical fact! Leopold Gmelin (Leopold Gmelin) - a professor of chemistry and medicine from Germany as early as 1848 introduced the term in official use, using the old German word “aketon”, which also came from the Latin “acetum”. This word subsequently became one of the main names for ketones or acetone in medicine.
Ketone bodies (these include acetone, acetoacetic acid, hydroxybutyric acid) are chemical compounds that are broken down by liver enzymes from foods entering the body. Almost all lipids (fats), as well as some proteins, are involved in their supply.
Until recently, ketonuria was quite rare and was most often diagnosed in the urine of children or pregnant women. This is due to the stage of formation of some organs (for example, the pancreas) in children and in pregnant women with an increase in the load on the mother's body. But now a similar deviation from the norm is often found in adult men and non-pregnant women.
In most people, ketone bodies are present in the body in small quantities - they are a separate type of energy source. Moreover, the excess of their concentration leads to disruption of the functioning of human organs and systems, exerting a toxic effect on them. Basically, with central acetonuria, the central nervous system suffers, although such as the digestive, respiratory or urinary tract get no less, and as a result, the person’s condition worsens.
In some cases, this process can proceed rapidly and even cause death. This condition develops against the background of lipid metabolism disorders and carbohydrate uptake. The most basic of the latter is glucose (sugar), regardless of where it enters the body - from food, dietary supplements, medications or in the process of cellular structures.
Its full assimilation is due to the sufficient synthesis of the pancreas hormone insulin, which is necessary for sugar processing. With a decrease in pancreatic performance, which means a decrease in insulin production, glucose enters the cells less than necessary, leading to their starvation.
To replenish the supply of carbohydrates in the cells, protein and lipids are broken down, as a result of which ketone bodies are released. If their content exceeds the level accepted for the norm (20-50 mg / day), then this condition is equated with dangerous for the functioning of the body and needs appropriate therapy.
Why does acetonuria develop?
The causes of the appearance of acetone in the urine have a fairly wide range, but their similarity lies in the improper (unbalanced) diet, which is a provoking factor. This includes a diet containing many protein products of animal origin, and neglect of the drinking regimen.
In addition, the negative effect of high air temperature (hot weather) and overwork during physical activity during sports or professional activities can be noted. Increased acetone in urine in adults is often observed due to a carbohydrate-free diet aimed at using the body's own reserves of fats and proteins.
Ketonuria in the above situations develops rapidly, but often after 2-3 days passes, and the composition of urine returns to normal characteristics. If acetone bodies are determined within 5 or more days, you should immediately visit a doctor for advice and a comprehensive diagnosis of the body.
Ketone bodies in urine can be both the primary manifestations of metabolic disturbances, and can be the result of pathological changes. Acetonuria, as a rule, is observed in parallel with acetonemia (acetone in the blood), since ketones from the blood begin to be eliminated intensively due to the last kidney, and they are transported to the urine.
Causes of a pathological nature that increase acetone in the urine are as follows:
- early stages of the development of tumors of the gastric mucosa and small intestine,
- leukemia, leukemia (malignant diseases of the hematopoietic system),
- thyrotoxicosis (increased production of thyroid hormones),
- injuries, operations accompanied by a decrease in glucose levels,
- damage to the liver parenchyma due to alcoholism,
- stenosis (narrowing of the lumen) of the esophagus or stomach,
- severe anemia (decreased hemoglobin),
- severe cachexia (excessive exhaustion),
- stress, nervous, mental overwork,
- decompensated diabetes mellitus,
- neoplasms in the brain,
- toxicosis during pregnancy,
- genital infections
Also, ketonuria can be observed with poisoning with heavy metal salts or prolonged use of drugs (antibiotics or atropine). You can read more about the appearance of acetone in urine in children in this article.
The main manifestations of elevated acetone in the urine
The very first signs of ketonuria at first, in most cases, appear slightly, and only the smell of acetone from the mouth can suggest that there were malfunctions in the body. As a rule, additional symptoms such as:
- decreased appetite, leading to the rejection of food and drink,
- the occurrence of nausea after eating or vomiting,
- the smell of acetone emanating from urine when urinating,
- violation of the function of the digestive system (constipation, diarrhea),
- spastic pain in the umbilical region,
- pallor and dryness of the skin and mucous membranes.
For the advanced form of the disease, the following symptoms are characteristic, developing gradually or rapidly increasing:
- sleep disturbance, insomnia,
- enlarged liver
- body intoxication,
- severe dehydration
Such manifestations require immediate hospitalization in a hospital, where it is necessary to pass a urine test for acetone, as well as all other tests to find out why this condition developed and what treatment should be prescribed. Read more about the appearance of acetone in the urine during pregnancy can be read in this article.
What to do with ketonuria
If a person’s condition is not critical, that is, poisoning of the body with ketone bodies has not yet manifested itself in the form of severe symptoms, then the first thing to do is to visit a doctor for a consultation. An anamnesis will be collected in the process, which is likely to shed light on the main causes of the development of ketonuria.Then, depending on the condition of the patient and the results of his analyzes, an appropriate therapeutic tactic will be developed - treatment on an outpatient basis or in a hospital setting.
If ketones are found in the urine, therapy will be carried out in several directions. In the presence of the underlying disease leading to acetonuria, measures should be taken to eliminate it or stabilize the patient's condition. For example, if the patient has diabetes, then he needs to regularly take insulin, as well as donate blood and urine for sugar. In addition, you need to control the diet.
The smell of acetone indicates the presence of toxins in excess of those defined as normal, so they should be removed. This can be done using adsorbents - Polysorb, Enterosgel or conventional activated carbon preparations.
Also for these purposes, cleansing enemas are used. If this condition developed in a pregnant woman against a background of toxicosis, then in order to reduce toxicity faster, infusion therapy is carried out.
In addition, if the urge to vomit allows you to take a little fluid, then it is recommended fractional drinking not too sweet tea or glucose solution. When ketone bodies are detected in the urine, patients are prescribed mineral water with alkaline components, as well as oral dehydration solutions, such as Regidron, Chlorazole and others. If the patient has a fever, antipyretic drugs and other symptomatic treatment are prescribed.
A very important point for curing the patient or stabilizing his condition with ketonuria is compliance with the main criteria for proper nutrition. Fatty meat broths, fried foods, citrus fruits, fruits and sweets should be excluded. At the same time, it is necessary to give preference to vegetable soups, cereals, low-fat types of meat and fish.
If there is no positive dynamics during outpatient treatment for 4-5 days, then the patient is hospitalized in a hospital and more intensive therapy is prescribed. It includes the introduction of drugs by drip, as well as complex measures that increase the effectiveness of treatment.
Self-determination of the level of ketone bodies
Urinary ketone levels are easy to determine at home, and this is a great opportunity, especially for patients with diabetes. There are special strips for determining acetone, which can be easily purchased at almost any pharmacy. It is easy to conduct such a test, and for women who have repeatedly resorted to determining pregnancy in this way, it will not be difficult to do it at all.
To do this, you need to collect a portion of morning urine, after having held the toilet of the genitals and plugging the entrance to the vagina with a cotton swab. Then lower the strip with a specially marked end into a container with urine, hold for a few seconds. Then shake off the remains of urine, wait a bit and compare the resulting shade with the color options indicated on the test packaging.
If the result has a pink tint, then this means the presence of ketones is higher than normal, but in a small amount. The violet color indicates a high content of acetone, which requires an immediate visit to a medical institution.
A well-known pediatrician and leading Komarovsky strongly recommends that parents with children with diabetes should always have test strips at home to determine acetone in their urine. This will allow you to control the condition of the child, which means being able to prevent serious complications in time, such as hyperglycemic coma.