Ketones urine test

Definition

A ketone urine test measures the amount of ketones in the urine.

Alternative Names

Ketone bodies - urine; Urine ketones; Ketoacidosis - urine ketones test; Diabetic ketoacidosis - urine ketones test

How the Test is Performed

Urine ketones are usually measured as a "spot test." This is available in a test kit that you can buy at a drug store. The kit contains dipsticks coated with chemicals that react with ketones. A dipstick is dipped in the urine sample. A color change indicates the presence of ketones.

This article describes the ketone urine test that involves sending collected urine to a lab.

A clean-catch urine sample is needed. The clean-catch method is used to prevent germs from the penis or vagina from getting into a urine sample. To collect your urine, the health care provider may give you a special clean-catch kit that contains a cleansing solution and sterile wipes. Follow instructions exactly.

How to Prepare for the Test

You may have to follow a special diet. Your provider may tell you to temporarily stop taking certain medicines that may affect the test.

How the Test will Feel

The test involves only normal urination. There is no discomfort.

Why the Test is Performed

Ketone testing is most often done if you have type 1 diabetes and:

Ketone testing may also be done if:

Normal Results

A negative test result is normal.

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

An abnormal result means you have ketones in your urine. The results are typically listed as small, moderate, or large as follows:

Ketones build up when the body needs to break down fats and fatty acids to use as fuel. This is most likely to occur when the body does not get enough sugar or carbohydrates.

This may be due to diabetic ketoacidosis (DKA). DKA is a life-threatening problem that affects people with diabetes. It occurs when the body cannot use sugar (glucose) as a fuel source because there is no insulin or not enough insulin in relation to the amount of glucagon in the blood. Fat is used for fuel instead.

An abnormal result may also be due to:

Risks

There are no risks with this test.

References

Murphy M, Srivastava R, Deans K. Diagnosis and monitoring of diabetes mellitus. In: Murphy M, Srivastava R, Deans K, eds. Clinical Biochemistry: An Illustrated Colour Text. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 32.

Sacks DB. Diabetes mellitus. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 47.


Review Date: 11/19/2023
Reviewed By: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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