The main causes of acetonuria
Acetonuria Is the excretion of acetone in the urine. Most often, this phenomenon is observed in children, but it can also occur in an adult.
Where does acetone come from in the human body? It would seem that this is a dangerous substance that can cause poisoning. In fact, it is. But, the fact is that acetone is a type of ketone bodies that may be needed in certain situations.
Eating food, a child and an adult receive glucose along with it, which is necessary to meet energy needs. Part of the glucose is converted into energy immediately, and the unclaimed glucose is stored in the form of glycogen. In extreme situations, such as fasting or strenuous physical exertion, it breaks down again to glucose, compensating for energy costs.
Glycogen stores are concentrated in the liver, skeletal muscles, and muscle tissue of internal organs. There are no glycogen stores in the brain, so timely snacks are important for successful mental work.
If the supply of glycogen is depleted or initially insufficient to cover the needs of the body, another substrate in the form of fats is used for energy. They break down into ketones, which serve as alternative energy sources.
Acetone is a type of ketone body.
Ketone bodies are needed to energize the brain in extreme situations. In large quantities, they are toxic to the body. First, acetone will appear in the blood. Later, it will be excreted by the kidneys in the urine.
Acetone in urine in children
Acetone in a child accumulates faster in the body than in adults. Glycogen stores in children under 7 - 8 years old are small, so situations when it is not enough occur more often.
Acetone in the urine of a child is found in the following cases.
- Diet disorderwhen the baby gets too much fatty foods, as well as foods containing preservatives, additives, dyes. In childhood, the ability to absorb fats is reduced.
- Starvation. Children have much less glycogen than adults, so the processes of fat breakdown begin faster, and acetone in urine is determined more often.
- Infectious diseases, which are accompanied by a rise in temperature and a serious condition. In this case, acetone in children is the result of decreased appetite and dehydration due to illness.
- Type 1 diabetes mellituswhen the baby's pancreas does not produce insulin. It is responsible for transporting sugar from the blood to the tissues. With diabetes mellitus, glucose remains in the blood. The child's body is forced to use other sources of energy in the form of fat reserves.
- Vomiting and loose stools during infectious and exacerbation of chronic diseases... Acetone in a child will rise all due to the same glucose deficiency. She simply will not be able to assimilate. Due to severe vomiting and a serious condition, the baby will simply refuse to eat and drink.
Acetone in urine in adults
In adults, acetonuria is less common and is often a sign of metabolic disorders, deterioration in diabetes mellitus, malignant tumors, poisoning, and coma.
Also acetone can appear in the following situations.
- Prolonged fasting, adherence to carbohydrate-restricted diets.
- Excessive consumption of protein and fatty foods.
- Increased physical activity during sports training or at work.
- Severe infectious or chronic diseases
- Alcohol abuse.
Acetonuria during pregnancy
The body of a pregnant woman is configured to bear and give birth to a child, therefore all metabolic processes are much more intense. Acetone in the urine of pregnant women appears in the situations described above, but they need to be treated more seriously and not be ignored.
In the early stages of pregnancy, acetonuria can be caused by toxicosis with indomitable vomiting, when the body simply does not eat. Naturally, to meet the needs of the mother and the fetus, fat reserves are used, and acetone appears in the urine.
In the later stages, gestational diabetes becomes the cause of the appearance of acetone in the urine. It is typical only for pregnant women and disappears after the birth of the baby.
For what symptoms does the pediatrician refer the child to determine the level of acetone in the urine?
Vigilance should be exercised when a child periodically has an unreasonable deterioration in well-being, which is accompanied by vomiting. Parents note their relationship with diet disorders. It is important to find out that vomiting in such cases is caused by an increase in acetone, and not a symptom of another, possibly very serious illness.
In diseases of internal organs, for example, the digestive system, the detection of acetone in the urine will also make it possible to assess the severity of the child's condition.
Diabetes - a dangerous disease with serious complications, which is important to recognize in time. A considerable percentage of children are diagnosed when ketones accumulate in the body, and a ketoacidotic coma develops.
It takes 2 to 4 weeks from the moment you stop producing insulin until coma develops!
Ketoacidosis itself can be easily confused with banal viral gastroenteritis or poisoning. They manifest themselves in the same way: feeling unwell, nausea, vomiting. It is possible to detect acetone in urine. To rule out diabetes, it is imperative to determine blood sugar.
The development of diabetes mellitus can be indicated by the appearance in a child who knows how to control urination, night and daytime urinary incontinence. It can also be suspected by the appearance of constant thirst and increased appetite against the background of weight loss. In such cases, it is best to check the amount of glucose in the blood.
For babies on insulin treatment, the acetone content in the urine will help keep the treatment under control.
Recommendations when preparing for analysis
Of course, if the baby's condition is serious, or complications of diabetes mellitus need to be excluded, then there can be no question of any preparation. In other cases, for the reliability of the analysis, it will not hurt to follow some rules for collecting urine.
Diet and medications
Since fats are the source of acetone, then 3 to 4 days before the collection of the analysis, food rich in fats, containing flavors, preservatives, and artificial colors, is excluded from the child's diet. It is recommended to comply with the drinking regime and avoid dehydration.
Parents should be aware that while taking some antibacterial and other drugs in the form of syrups that contain flavors and dyes, it is also possible to increase the level of acetone in the urine. In adults, a false-positive result can occur while taking drugs against Parkinson's disease.
Hygiene
Before collecting urine, rinse the child's external genitalia with warm water. PH neutral baby hygiene products can be used. Otherwise, it may be unreliable due to the ingress of elements from the skin and genital tract there.
How to collect urine correctly and can it be stored for a long time?
To collect urine, it is better to use sterile containers that are sold at the pharmacy. If non-pharmaceutical dishes are used, they must be washed well in running water and boiled together with the lid. Urine bags have been developed for infants. They are also sterile and adhere to the skin, allowing mom and dad not to wait, and the baby does not feel discomfort during the collection procedure.
It is unacceptable to pour urine from pots, plates, etc. In this case, the analysis is likely to be unreliable.
In children who control the process of urination, for a more reliable result, it is better to take a middle portion of urine for analysis, that is, skip the first trickles.
The collected urine test should be delivered to the laboratory within 1.5-2 hours. Otherwise, decomposition processes begin. The analysis will be unreliable. In modern laboratories, special containers with a preservative can be purchased. In such cases, the analysis can be delivered within a day.
Interpreting Results
Normally, the concentration of ketone bodies in urine should not exceed 1 mmol / liter. Modern laboratory analyzers do not determine specific numbers, but the presence of ketones. It is evaluated with a "+" sign and ranges from "+" to "++++".
Norm
Acetone is normally always present in an insignificant amount that cannot be determined. In this case, the research form will contain the words “negative” or “negative”.
Sometimes, after small errors in the diet, ketone bodies are defined as "+", or "trace", which means trace amounts. In most cases, this is also a variant of the norm, which does not require any treatment. An exception is diabetes mellitus.
Deviations from the norm
If the analysis revealed acetone in amounts of "++" and more, then this is already a manifestation of trouble in the body. A doctor's consultation is required, possibly further examination, correction of treatment. The result "++++" in most cases will require hospitalization of the child.
Additional examination of a child if acetone is found in urine
Usually, additional examinations are prescribed when the child is in serious condition, when the presence of acetone in the urine is accompanied by other clinical manifestations. In other cases, only a control urine test is taken.
If acetone is detected in urine for the first time, then diabetes mellitus is necessarily excluded. The doctor must carefully collect complaints from parents, pay attention to such important symptoms as thirst, weight loss against the background of increased appetite, and sudden urinary incontinence. The blood sugar level is measured without fail.
A general blood test will reveal inflammatory changes in the body. If acetonuria is due to a cold, it can be used to assess the severity of the condition and the possibility of complications.
To exclude diseases of the liver, kidneys, pancreas, a biochemical blood test, ultrasound examination of the abdominal organs and kidneys will be needed.
Approaches to the treatment of acetonuria
If the appearance of acetone in the urine is not a symptom of diabetes mellitus or pathology of internal organs, then no special treatment is required. You need to make every effort to compensate for the underlying disease.
In case of infectious diseases, which are accompanied by a rise in temperature, vomiting, loose stools, it is imperative to water the baby. For this, sweet tea, compote, water with sugar, not sour fruit drink or special solutions that are sold at the pharmacy are suitable. If vomiting is indomitable, frequent, or the child refuses to drink, 15-20 ml of liquid is offered every 15-20 minutes. As a rule, with this scheme, the drink is well absorbed.
If the accumulation of ketone bodies is associated with a low resistance to hunger, you need to have sweet candies, marmalade or cookies on hand. At the first signs of starvation, it is imperative to give them to the child in order to prevent an increase in the level of acetone.
Diet with acetonuria
If it is proven that an increase in the level of acetone is associated with inaccuracies in nutrition, it can be prevented by following simple dietary recommendations.
- We limit fatty, fried foods in the child's diet. Smoked products should not be given to children. Sausages are not a complete source of protein. They can also contain a large amount of fat, as well as harmful food additives.
- We limit or completely exclude products containing artificial flavors, colors, preservatives. You need to carefully study the labels and be sure to look at the shelf life. Natural products cannot be stored for a long time!
- Limiting chocolate. At first glance, it is a source of carbohydrates. But chocolate contains a lot of fat.
- If possible, we organize 5-6 meals a day for the child so that he does not remain hungry. For school-age children, breakfast is required at home.
- A source of carbohydrates can be sweet cereals, vegetable purees and salads, pasta... From sweets, marmalade, marshmallow, cookies without additives, marshmallows, fruits are preferable.
- If a child is sick, drinking is very important. We offer the sick baby to eat a little, if he refuses, then we strongly solder it.
Dangerous condition for the baby, prognosis
The accumulation of acetone due to dietary disorders or against the background of an illness is an age-related feature of metabolism. Children usually outgrow this condition by the age of 8 to 12. In the future, it does not lead to the development of any pathology. The main danger for these children is acetone vomiting and, as a result, dehydration.
The situation is different if acetone in the urine was found against the background of a chronic disease of internal organs. This is a signal of trouble in the body, which requires correction of treatment.
The most dangerous for a child's life will be the combination of acetonuria with increased thirst and appetite against the background of dramatic weight loss and urinary incontinence. The first signs of diabetes are evident! If you do not take action, a ketoacidotic coma will soon develop with serious consequences and even death.
In children with an already established diagnosis of diabetes mellitus, the appearance of acetone in the urine is also not a good sign. This is an indication that the insulin dose was chosen incorrectly, or the appointment was not followed. The consequence can be the same ketoacidotic coma and the death of the child.
Conclusion
The detection of acetone in the urine of a baby requires attention and further monitoring. Most often this is an unpleasant, but not dangerous condition. However, in order not to miss a formidable disease, it is better to play it safe.
