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Ketones in Urine

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What are ketones in a urine test?

The test measures ketone levels in your urine. Normally, your body burns glucose (sugar) for energy. If your cells don’t get enough glucose, your body burns fat for energy instead. This produces a substance called ketones, which can show up in your blood and urine. High ketone levels in urine may indicate diabetic ketoacidosis (DKA), a complication of diabetes that can lead to a coma or even death. Ketones in the urine test can prompt you to get treatment before a medical emergency occurs.

Other names: ketones urine test, ketone test, urine ketones, ketone bodies

What is it used for?

The test is often used to help monitor people at a higher risk of developing ketones. These include people with type 1 or type 2 diabetes. If you have diabetes, ketones in urine can mean that you are not getting enough insulin. If you don’t have diabetes, you may still be at risk for developing ketones if you:

  • Experience chronic vomiting and/or diarrhoea
  • Have a digestive disorder
  • Participate in strenuous exercise
  • Are on a very low-carbohydrate diet
  • Have an eating disorder
  • Are pregnant

Why do I need a ketones in urine test?

Your health care provider may order a ketones in urine test if you have diabetes or other risk factors for developing ketones. You may also need this test if you have symptoms of ketoacidosis. These include:

  • Nausea or vomiting
  • Abdominal pain
  • Confusion
  • Trouble breathing
  • Feeling extremely sleepy

People with type 1 diabetes are at a higher risk for ketoacidosis.

What happens during a ketones in urine test?

A ketones in urine test can be done in the home as well as in a lab. If in a lab, you will be given instructions to provide a “clean catch” sample. The clean catch method generally includes the following steps:

  1. Wash your hands.
  2. Clean your genital area with a cleansing pad. Men should wipe the tip of their penis. Women should open their labia and clean from front to back.
  3. Start to urinate into the toilet.
  4. Move the collection container under your urine stream.
  5. Collect at least an ounce or two of urine into the container, which should have markings to indicate the amount.
  6. Finish urinating into the toilet.
  7. Return the sample container as instructed by your health care provider.
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If you do the test at home, follow the instructions that are in your test kit. Your kit will include a package of strips for testing. You will either be instructed to provide a clean catch sample in a container as described above or to put the test strip directly in the stream of your urine. Talk to your health care provider about specific instructions.

Will I need to do anything to prepare for the test?

You may have to fast (not eat or drink) for a certain period of time before taking a ketones in urine test. Ask your health care provider if you need to fast or do any other type of preparation before your test.

Are there any risks to the test?

There is no known risk to having a ketones in urine test.

What do the results mean?

Your test results may be a specific number or listed as a “small,” “moderate,” or “large” amount of ketones. Normal results can vary, depending on your diet, activity level, and other factors. Because high ketone levels can be dangerous, be sure to talk to your health care provider about what is normal for you and what your results mean.

Is there anything else I need to know about a ketones in urine test?

Ketone test kits are available at most pharmacies without a prescription. If you are planning to test for ketones at home, ask your health care provider for recommendations on which kit would be best for you. At-home urine tests are easy to perform and can provide accurate results as long as you carefully follow all instructions.

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Some people use at-home kits to test for ketones if they are on a ketogenic or “keto” diet. A keto diet is a type of weight-loss plan that causes a healthy person’s body to make ketones. Be sure to talk to your health care provider before going on a keto diet.

References

  1. American Diabetes Association [Internet]. Arlington (VA): American Diabetes Association; c1995–2017. DKA (Ketoacidosis) & Ketones; [updated 2015 Mar 18; cited 2017 Mar 19]; [about 3 screens]. Available from: http://www.diabetes.org/living-with-diabetes/complications/ketoacidosis-dka.html?referrer
  2. Hinkle J, Cheever K. Brunner & Suddarth’s Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Ketones: Urine; p. 351.
  3. Joslin Diabetes Center [Internet]. Boston: Joslin Diabetes Center, Harvard Medical School; c2017. Ketone Testing: What You Need to Know; [cited 2017 Mar 19]; [about 3 screens]. Available from: http://www.joslin.org/info/ketone_testing_what_you_need_to_know.html
  4. Lab Tests Online [Internet]. American Association for Clinical Chemistry; c2001–2017. Urinalysis: Three Types of Examinations; [cited 2017 Mar 19]; [about 5 screens]. Available from: https://labtestsonline.org/understanding/analytes/urinalysis/ui-exams/start/1#ketones
  5. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2017. Urinalysis; [cited 2017 Mar 19]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/diagnosis-of-kidney-and-urinary-tract-disorders/urinalysis
  6. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Managing Diabetes; 2016 Nov [cited 2017 Mar 19]; [about 4 screens]. Available from: https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes
  7. Paoli A. Ketogenic Diet for Obesity: Friend or Foe? Int J Environ Res Public Health [Internet]. 2014 Feb 19 [cited 2019 Feb 1]; 11(2): 2092-2107. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945587
  8. Saint Francis Health System [Internet]. Tulsa (OK): Saint Francis Health System; c2016. Patient Information: Collecting a Clean Catch Urine Sample; [cited 2017 Apr 13]; [about 3 screens]. Available from: https://www.saintfrancis.com/lab/Documents/Collecting%20a%20Clean%20Catch%20Urine.pdf
  9. Scribd [Internet]. Scribd; c2018. Ketosis: What is ketosis? [updated 2017 Mar 21;[ cited 2019 Feb 1]; [about 2 screens]. Available from: https://www.scribd.com/document/368713988/Ketogenic-Diet
  10. The Johns Hopkins Lupus Center [Internet]. Johns Hopkins Medicine; c2017. Urinalysis; [cited 2017 Mar 19]; [about 3 screens]. Available from: https://www.hopkinslupus.org/lupus-tests/screening-laboratory-tests/urinalysis/
  11. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida; c2019. Ketones  urine test: Overview; [updated 2019 Feb 1; cited 2019 Feb 1]; [about 2 screens]. Available from: https://ufhealth.org/ketones-urine-test
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Ketone Bodies (Urine); [cited 2017 Mar 19]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid;=ketone_bodies_urine
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