Acetone in a child's urine

Every second person whose blood shows a slight increase in the amount of glucose eventually runs the risk of becoming diabetic and developing a dangerous disease. Depending on the degree of its severity, as well as taking into account the individual characteristics of the body, dangerous disorders may arise and develop, covering various organs and systems. Acetone in urine in diabetes mellitus is considered one of the most common pathologies.

The mechanism of formation of acetone in urine in diabetes mellitus

Diabetes mellitus is an incurable autoimmune disease, the mortality rate of which is currently very high. One of the dangerous complications of this pathology is the occurrence of ketoacidosis, which occurs due to metabolic disorders in the human body. A distinctive sign of this condition is the appearance of acetone (ketone bodies) in the patient’s urine and blood.

To fully understand the reasons and mechanism for the formation of acetone, it is necessary to understand some of the chemical processes occurring inside the human body. The main supplier of energy and vitality should be considered glucose, which enters the body from a variety of foods. Its normal absorption can only occur through interaction with a special hormone - insulin, produced by the human pancreas.

Splenic rupture is a serious pathology that occurs as a result of a violation of the integrity of this organ as a result of any impact. The spleen is an organ of the human body located on the left side of the sternum. Read more in the article: “consequences of splenic rupture.”

If there is insufficient intake or complete absence, which occurs in type 1 diabetes, glucose is not absorbed by the body and cellular starvation occurs. The brain constantly signals a lack of glucose for energy synthesis. Then the cells begin to intensively process their own endogenous fats and proteins, forming ketone bodies (acetone) first in the blood and then in the urine.

Comparison chart of type 1 and 2 diabetes

Acetonuria in diabetes

Diabetes mellitus is a chronic disease that currently cannot be completely cured. One of the most severe complications of this pathology is ketoacidosis. This is a metabolic disorder, in which the acid-base balance in the patient’s body shifts to the acidic side. As a result, ketone bodies appear in the patient’s blood and urine. Their appearance indicates a severe disorder in the functioning of the endocrine system.

When a baby systematically reaches his hands towards his butt, you can’t help but pay attention to it. Since such signs may indicate the development of certain diseases in children. Read more in the article: “causes of itching in the anus in a child.”

Normally, human urine should contain no more than 0.5 mmol/liter of ketone bodies. Exceeding this level causes disruption in the functioning of various organs and systems. In the absence of timely treatment, ketoacidosis leads to the development of a coma and death.

Ketoacidotic coma is an acute complication of diabetes that develops due to the lack of insulin therapy. Manifested by weakness, adynamia, disorder of consciousness. On average, this disorder occurs in 40% of patients.

Detection of acetone in urine

Diagnostics of acetone in the body

In recent years, the procedure for detecting acetone in urine has been significantly simplified. If the patient has the slightest suspicion of acetonuria, then he simply needs to purchase special tests in the form of strips from the pharmacy:

• This procedure must be carried out for three days in a row on morning urine.
• The container with the liquid must be carefully lowered into the test strip, remove it and wait just a few minutes.
• The yellow stripe turning pink indicates that acetone is present in the body.
• If the test strip turns purple, this is an indication that acetonuria is progressing in the patient’s body.

Of course, the test is unable to show exact numbers, however, it shows the level of acetone that requires immediate contact with a specialist.

In order to determine the level of acetone in the human body, the doctor prescribes a clinical urine test.

Typically, urine collection is carried out in the morning after all hygiene procedures have been completed. In a healthy person, ketone bodies are present in human urine in such minute quantities that laboratory methods are not even able to detect them. It is for this reason that the normal result is the complete absence of acetone in human urine.

• Causes and methods of eliminating bad breath in diabetes

In case of a weakly positive reaction to acetone, one plus is placed on the results form, and in case of a positive result, the laboratory assistant indicates two or three pluses. In case of a sharply positive reaction, which is marked by four pluses, immediate hospitalization of the patient and provision of medical care is required.

Causes of acetonuria

This disease usually occurs in diabetes mellitus. With this pathology, the amount of carbohydrates drops sharply. If a urine test shows acetone, and the patient complains of a strong odor, first of all, it is necessary to check blood sugar levels - it will help to exclude a serious illness.

Abuse of food, which is high in fat and protein, provokes the accumulation of acetone in the urine. In this case, there is a lack of carbohydrates. A strict diet or long-term fasting can negatively affect the acid-base balance. Enzyme deficiency is also a provoking factor. If there are few of them, carbohydrates are poorly digested.

The appearance of acetonuria is promoted by stress, increased physical activity, and exacerbation of chronic pathologies. Other reasons why adults experience acetone in the urine that requires treatment include:

• food poisoning;
• hypothermia;
• infectious diseases with fever;
• oncological diseases;
• mental disorders;
• intestinal infections;
• toxicosis during pregnancy;
• alcohol poisoning.

If acetone is caused by any illness, you should undergo an appropriate course of therapy.

Acetone in the urine of pregnant women

In addition to the general factors that cause increased acetone levels, there are special reasons that lead to this phenomenon during pregnancy.

• Diabetes control

One of these reasons can be called early toxicosis, which manifests itself in the first trimester of pregnancy. As a result of frequent vomiting, food cannot be properly digested, appetite becomes much worse, which leads to dehydration of the body - this leads to the fact that the level of acetone in the urine of a pregnant woman becomes increased. The main symptoms of this disease will help determine this - the specific smell of urine, feces and vomit, which have the smell of acetone or acid. Also, the expectant mother has bad breath, since this smell also resembles acetone.

Another common cause of acetonuria is gestational diabetes, which is dangerous for the health of children. It often leads to rapid weight gain in the fetus, which threatens the development of serious pathologies. Therefore, if a urine test during pregnancy shows an elevated level, a repeat test is first performed to rule out a medical error, and then an in vitro blood test is prescribed to determine blood sugar, allowing a correct diagnosis to be made.

Since acetone in the urine of pregnant women is a sign of pathology, there is no special treatment to reduce the risk of its occurrence. This means that the main treatment should be aimed at ridding the expectant mother of the underlying disease. If the main cause of acetone is toxicosis in the first trimester of pregnancy, it is important to maintain the correct drinking balance. In case of severe toxicosis, a woman should drink a lot of water, but this should be done in small portions - this will prevent further vomiting during pregnancy.

In a hospital setting, the expectant mother is prescribed an intravenous infusion of an infusion solution, and after the condition improves, a high-carbohydrate diet is prescribed. If the main symptoms of the disease are caused by gestational diabetes, a special diet is prescribed to treat it, excluding most foods with sugar and carbohydrates. If necessary, insulin administration and adherence to minimal exercise are prescribed.

Symptoms of acetonuria

Acetonuria indicates the development in the patient’s body of pathological processes in the functioning of various organs and systems. The symptoms of the disorders gradually become more pronounced, significantly worsening the patient’s quality of life. Moreover, the signs of acetonuria directly depend on the severity of the syndrome in the patient. There are four main phases of pathology:

• mild
  : the violation can only be detected by analysis;
• medium
  : the patient begins to complain of a specific smell from the mouth, weakness;
• severe
  : the patient has pronounced clinical symptoms of the disorder;
• coma
  : sudden disruption of vital systems, loss of consciousness.

At the beginning of the development of the pathology, the patient complains of weakness, drowsiness, and decreased cognitive function. These signs are caused by a deficiency of glucose in the tissues and their energy starvation. Gradually, due to the synthesis of acetone in the body, the patient develops a constant feeling of thirst, against the background of which polyuria develops - the release of more than 2-2.5 liters of urine per day. These symptoms are especially pronounced in the evening and at night.

Acetonuria can be diagnosed in the early stages of the pathology by the characteristic odor from the patient’s mouth.

Gradually, due to metabolic disorders, the patient develops problems in the functioning of the digestive system, he is bothered by attacks of nausea and periodic vomiting. As acetonuria develops, other specific symptoms appear:

• drop in blood pressure;
• pathologically weak reaction of the pupils to a light stimulus;
• dysfunction of both the central and peripheral nervous systems, neuropathy;
• dyspepsia: flatulence, diarrhea, vomiting of undigested food;
• unstable mental state, psychosis, constant mood swings;
• low-grade fever;
• strong unpleasant odor of urine when urinating;
• pathologically high blood glucose levels;
• signs of dehydration: dry pale skin and mucous membranes, cracks on the lips and in the corners of the eyes, brittle nails and hair;
• the appearance of crimson spots on the face;
• intense cephalalgia.

In the absence of therapy, the patient experiences frequent fainting, and various reflexes gradually slow down due to disruption of metabolic processes in the body. A characteristic sign of the pathology is hepatomegaly - abnormal enlargement of the liver. Acetonuria also leads to dysfunction of the cardiovascular and respiratory systems, which is why the patient experiences heavy breathing.

With the development of ketoacidotic coma, the patient experiences specific Kussmaul breathing - rare, noisy, caused by acute metabolic acidosis.

Diagnosis of acetonuria

Diagnosis of acetonuria involves conducting various urine tests. The simplest and fastest to carry out is a clinical analysis, however, the daily volume of urine is most often examined. This study allows you to obtain complete information about the dynamic changes in the patient’s parameters during the day. The specialist may also prescribe the following tests:

• urine analysis according to Nechiporenko;
• three-glass sample;
• rapid test.

The last study is carried out at home or in a medical clinic during emergency hospitalization of a patient in a diabetic coma.

Clinical urine analysis

Often, for the primary diagnosis of acetonuria, a specialist prescribes a general urinalysis for the patient. Urine for research must be collected as follows:

1. In the morning after sleep, perform thorough hygiene of the genitals.
2. Prepare a clean and dry glass or plastic container with a tight-fitting lid.
3. Collect an average portion of urine of about 150 ml in a container.
4. Deliver the analysis to the laboratory within 2-3 hours.

Normally, there should be no acetone in the urine, or its amount may be so small that standard diagnostic measures cannot detect it. If a person suffers from acetonuria, then the levels of ketone bodies in urine are exceeded several times. In case of mild pathology, the laboratory technician indicates the presence of acetone with a “plus” sign. Two or three “pluses” indicate a clearly positive reaction. Four “pluses” are evidence of severe ketoacidosis, which requires urgent medical intervention.

Test strips for determining acetonuria

To independently determine acetonuria at home, there are special test strips. Carrying out such an analysis does not require preliminary preparation and takes a few minutes. The research methodology may vary slightly among different manufacturers.

Typically diagnosis is carried out as follows:

1. Carry out hygiene of the external genitalia.
2. Collect urine in pre-prepared sterile or clean and dry containers.
3. Immerse the test strip in urine to a certain point
4. After 2-5 seconds, carefully remove the test strip from the urine container, removing excess urine with a tissue.
5. Wait for 60-90 seconds. During this time, the line on the test strip coated with the reagent should change color in accordance with the scale given in the instructions.

The most common test strips are Ketur-test, Acetontest and Ketostix.

The level of acetone in the urine should not exceed 3.5 mmol/liter. Exceeding this level is a sign of serious disturbances in the functioning of the body. If an excessive level of acetone is detected, it is recommended to take the test again in the laboratory of a medical clinic and urgently seek advice from a specialist.

Diagnostics

Today, the procedure for determining the level of acetone has been significantly simplified - for this, there are rapid tests that parents can independently purchase at the nearest pharmacy.

The test should be done within three days. The strip is dipped into morning urine, shaken off and after a few minutes you get the result:

• if the initially yellow line on the test turns pink, this indicates the presence of a low level of ketone bodies in the urine;
• if it has acquired a purple tint, it means that the level of acetone in the urine is extremely high and the child requires hospitalization.

Of course, parents should not rely solely on test results - if you suspect acetone, you should urgently contact a pediatrician who will prescribe an examination and tests.

For testing, urine is collected in the morning in a dry and clean container. The norm is when acetone is not detected in the child’s urine. If ketone bodies are present even in small quantities, this is marked in the analysis with “crosses” (pluses). The number of “crosses” indicates the level of ketone bodies in the urine:

• 1 plus indicates a weakly positive result;
• 2-3 pluses means the reaction is clearly positive;
• 4 pluses indicate a pronounced reaction when the child requires immediate treatment.

Pathology treatment methods

Therapy is selected taking into account the specific diagnosis. If acetone appears in the urine during diabetes, it is necessary to monitor the amount of sugar in the blood, and if there is a metabolic disorder, quickly replenish energy reserves. If your child smells acetone, do the following:

1. For children under ten years of age, measure your sugar level.
2. If you don’t have diabetes, but you feel the smell for the first time, drink sweet tea. For vomiting and infections, the patient should be given drinks and food containing sugar.
3. Manifestations of acetonuria in diabetics require urgent medical attention. When the condition returns to normal, it is important to reconsider your diet and habits.

If the smell of acetone in the urine is observed in an adult or teenager, it is necessary to undergo a comprehensive examination. It will help identify severe pathologies, assess the condition of the kidneys and liver containing carbohydrates, and drink more fluids. If your health worsens, it is better to consult a specialist.

Treatment of acetonuria should be started as early as possible to prevent possible complications. The best option is to talk to a specialist who will give valuable recommendations. In the absence of vomiting, convulsions and other dangerous symptoms, you can cope with the problem yourself:

1. If a characteristic odor appears, get tested to determine the amount of glucose in the blood.
2. A cleansing enema will help remove ketone bodies. You can also take enterosorbents: Polysorb, Smecta, Enterosgel.
3. In the presence of infections, it is important to increase the amount of glucose. To do this, you can drink sweet tea, a decoction of dried fruits, mineral water, specialized solutions, for example, Regidron.

Additionally, the doctor may prescribe injections to eliminate vomiting, vitamin complexes, and analgesics for severe pain. Intravenous drips will help restore water balance.

Urine test for acetone

A urine test for acetone is a comprehensive study that determines the presence in the urine of a whole group of metabolic products - ketone bodies. They are formed in the liver and are normally excreted in urine in such small quantities that it is impossible to isolate their presence using a normal qualitative reaction. A positive qualitative reaction to ketone bodies indicates that their concentration in the urine (and, accordingly, in the blood) is many times higher. Ketone bodies include acetone itself, as well as acetoacetic and beta-hydroxybutyric acids.

Why is an increase in acetone in urine dangerous?

If ketone bodies accumulate in the blood, this leads to the development of acetone syndrome. The disorder may be short-term (transient) or persist for a long time. A long-lasting positive urine reaction to acetone may indicate the presence of a serious disorder in the functioning of internal organs.

The cause of acetonuria can be diabetes mellitus (not even diagnosed yet), hyperthyroidism, toxic and inflammatory processes in the liver, and intracranial neoplasms. In children, acetonuria often indicates eating disorders.

Both the causes that cause this condition and the acetonemic syndrome itself are a dangerous condition that can threaten the patient’s life.

One of the extremely dangerous findings is acetone in the urine during pregnancy. Already in the first trimester it can be a manifestation of severe gestosis. Later - become a manifestation of disorders of the endocrine system.

How does acetonemic syndrome manifest?

The first sign of an increase in the concentration of acetone in the blood is a characteristic acetone odor from the mouth. It is difficult to confuse it with anything: the person smells distinctly of nail polish remover. This is a reason to “sound the alarm” and urgently consult a doctor. At this stage, help will be quite simple: the doctor will prescribe plenty of alkaline drinks and a diet.

If the condition progresses, vomiting and convulsions may develop due to dehydration and disturbances in the acid-base balance in the body.

How to prepare for analysis

A urine test for ketone bodies is performed in the same way as a general urine test, that is:

• before the study, it is not recommended to consume alcohol, salty, spicy foods, or foods that change the color of urine;
• diuretics are excluded;
• Women do not get tested during menstruation;
• urine is collected in the morning after toileting the genitals.

Measures to prevent acetonuria

In order to prevent negative changes in the functioning of vital organs and metabolic disorders, it is recommended to undergo regular scheduled examinations and annual full-scale diagnostics in order to prevent exacerbations. To prevent the development of ketoacidotic coma, you should regularly test your urine for the presence of acetone and conduct rapid tests at home.

Diet is considered an integral part of prevention. The daily diet should be designed in such a way as to prevent the formation of glucose deficiency and excess fat. This should be done by a nutritionist. The patient just has to listen to the nutritionist’s advice and adhere to certain nutritional principles.

1. Maintaining a strict meal schedule. The maximum time deviation is no more than 10-15 minutes.
2. Meals should be frequent and small. For breakfast and dinner, you should eat light and low-calorie meals.
3. The dose of insulin should correspond to the amount of carbohydrates consumed per day. Each time it should be calculated again, and based on this, the volume and frequency of drug administration should be changed.

The basis of nutrition should be foods that are slowly absorbed. The menu should include foods rich in fiber and complex carbohydrates. The following are considered permitted: fruits, vegetables, herbs, lean meats and fish, all types of fermented milk products, cereals, jelly and fruit drinks, as well as herbal or green tea.

At the same time, it is recommended to completely eliminate or limit as much as possible the consumption of trans fats and quickly digestible carbohydrates. The list of prohibited products includes: smoked meats and sausages, marinades and pickles, fatty meat and broths based on it, alcohol, coffee, pasta, dried fruits, white bread and pastries. Acetonuria is a clinical syndrome characterized by the release of acetone due to impaired glucose metabolism. In order to stop the pathology, it is recommended to carry out insulin therapy, follow preventive measures and regularly visit an endocrinologist.

Dietary features of a patient with acetonuria

{banner_banstat8}

Diabetic acetonuria is a pathology that occurs in patients with diabetes due to impaired glucose metabolism. With this syndrome, acetone is released from the body in the urine. To stop the pathology, it is necessary to carry out insulin therapy in a timely manner, follow a diet and follow the instructions of a specialist.