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2014 ; 14
(2
): 47-52
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Comparing Finger-stick ?-Hydroxybutyrate with Dipstick Urine Tests in the
Detection of Ketone Bodies
#MMPMID27331169
Kuru B
; Sever M
; Aksay E
; Dogan T
; Yalcin N
; Eren ES
; Ustuner F
Turk J Emerg Med
2014[Jun]; 14
(2
): 47-52
PMID27331169
show ga
OBJECTIVES: Blood ketone (beta-hydroxybutyrate) measurements are suggested
instead of urine ketone (acetoacetate) measurements in the diagnosis of diabetic
ketoacidosis. Urine ketone examination is difficult and time consuming, and may
result in an incorrect interpretation. Studies performed in emergency departments
on blood ketones are limited. Our objective is to compare urine ketones and
capillary blood ketones in patients whose serum glucose levels were ?150 mg/dl.
METHODS: In our cross-sectional prospective study, finger-stick blood
beta-hydroxybutyrate, arterial blood gas and urine ketone measurements of
patients whose serum glucose levels were 150 mg/dL and higher were performed in
the emergency department. RESULTS: A total of 265 patients were included in the
study. The mean age of the patients was 62.4±14.9 years, and 65.7% of them were
female. The mean of the capillary blood ketone levels of the patients was
determined to be 0.524±0.9 mmol/L (min: 0 mmol/L, max: 6.7 mmol/L). In 29 (13.1%)
of the 221 patients whose urine ketone levels were negative, the finger-stick
blood ketone levels were positive. Three of these patients were severely
ketonemic, six were moderately ketonemic, and 20 were mildly ketonemic.
CONCLUSIONS: In patients admitted to the emergency department with a blood
glucose level of 150 mg/dL or higher, performing a capillary blood ketone
measurement instead of a urine ketone measurement was a better predictor of
ketonemia.
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