Lab Med Online LMO Laboratory Medicine Online 2093-6338 The Korean Society for Laboratory Medicine 10.3343/lmo.2012.2.1.3 Original Article Clinical Chemistry Evaluation of the Clinical Significance of Ketonuria Jung Hae-Won M.D. 1 Park Ile-Kyu M.D. 2 Department of Laboratory Medicine, Hanyang University Hospital, Seoul, Korea. Department of Laboratory Medicine, Hanyang University Kuri Hospital, Guri, Korea. Corresponding author: Ile-Kyu Park, M.D. Department of Laboratory Medicine, Hanyang University Kuri Hospital, 249-1, Gyomun-dong, Guri 471-701, Korea. Tel: +82-31-560-2573, Fax: +82-31-560-2585, ikpark@hanyang.ac.kr 01 2012 01 01 2012 2 1 15 19 28 03 2011 19 09 2011 19 09 2011 © 2012, Laboratory Medicine Online 2012

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 Background

Urine ketone test is commonly used to screen for diabetic ketoacidosis (DKA). Ketonuria also develops in patients with disease conditions other than DKA. However, the prevalence of DKA in patients with ketonuria is not known. We investigated the prevalence of ketonuria and characteristics of patients with ketonuria and estimated the prevalence of DKA among them to study the clinical significance of ketonuria as an indicator of DKA.

 Methods

We studied 1,314 adult and 1,027 pediatric patients who underwent urinalysis. The prevalence of ketonuria in the different groups of patients, classified according to the types of their visits to the institution, was investigated, and the relationships between ketonuria and albuminuria, glycosuria, and bilirubinuria were evaluated.

 Results

The overall prevalence of ketonuria was 9.1%. The prevalences of ketonuria in adult and pediatric patients were 4.3% and 15.2%, respectively. The prevalences of ketonuria were the highest in the adult (9.7%) and pediatric (28%) patients in the group that had visited the emergency department. Among patients with ketonuria, 7% adult and 3.8% pediatric patients showed glycosuria.

 Conclusions

This study showed that the prevalence of DKA in patients with ketonuria, defined as the simultaneous presence of ketone bodies and glucose in urine, was only 7%. Therefore, we concluded that ketonuria might be clinically significant as an indicator of acute or severe disease status rather than of DKA.

 Ketonuria Urine ketone Diabetic ketoacidosis

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Ketonuria in adult patients classified according to the types of their visits to the hospital

Chi-square test between the 4 groups (P<0.01).

Abbreviations: ED, emergency department; OP, outpatient; IP, inpatient; C/U, check-up.

Ketonuria in pediatric patients classified according to the types of their visit to the hospital

Chi-square test between the 3 groups (P<0.01).

Abbreviations: ED, emergency department; OP, outpatient; IP, inpatient.

Association between ketonuria and albuminuria, glycosuria, and bilirubinuria in 1,314 adult patients

Association between ketonuria and albuminuria, glycosuria, and bilirubinuria in 1,027 pediatric patients