Correlation between urine ketones (acetoacetate) and capillary blood ketones (3-beta-hydroxybutyrate) in hyperglycaemic patients

Taboulet, P.; Deconinck, Nicolas; Thurel, A.; Haas, Laurent; Manamani, J.; Porcher, Raphaël; Schmit, C.; Fontaine, Jean-Paul; Gautier, Jean‐François

doi:10.1016/j.diabet.2006.11.006

Cited by 58 publications

(42 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similarly, in human medicine, a cut-off value of capillary 3-HB >3.0 mmol/L is indicative of DKA [27], and studies in veterinary medicine identified a cut-off value of venous 3-HB >3.8 mmol/L [7] and >3.5 mmol/L [6], respectively, as indicative of DKA. Conversely, no cut-off values were detected for urinary AcAc to diagnose DKA, in both human [23,25] and veterinary medicine [6,7]. …”

Section: Discussionmentioning

confidence: 99%

“…Urinary or plasma semiquantitative measure of AcAc is associated with a considerable risk of false positive and negative results, both in humans and animals [3,6,23,27,32]. Finally, obtaining a urine sample for a rapid diagnosis may be difficult in emergency cases [3,25,27,32]. For this reason, in human medicine, blood ketones are now measured using a hand-held electrochemical sensor that measures 3-HB in 30 sec using capillary whole blood samples [1,25,27,28].…”

Section: Introductionmentioning

confidence: 99%

“…Finally, obtaining a urine sample for a rapid diagnosis may be difficult in emergency cases [3,25,27,32]. For this reason, in human medicine, blood ketones are now measured using a hand-held electrochemical sensor that measures 3-HB in 30 sec using capillary whole blood samples [1,25,27,28]. This method is actually the recommended method for diagnosis and monitoring of the treatment of DKA, and can be used for the home monitoring of diabetic patients [1,10,12,18,25,26,27,28].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis

et al. 2014

View full text Add to dashboard Cite

In human medicine, diagnosis of diabetic ketoacidosis (DKA) is usually based on measurement of capillary 3-β-hydroxybutyrate (3-HB) with a hand held ketone sensor. This study was conducted to determine if measurement of capillary 3-HB could be useful for the diagnosis and monitoring of canine DKA. Fifteen dogs with diabetic ketosis and 10 with DKA were evaluated. Paired measurements of 3-HB of capillary and venous blood samples were analysed by the electrochemical sensor and reference method. Use of capillary 3-HB measurement during DKA management was then evaluated through simultaneous measurements of capillary 3-HB, urinary AcAc and venous blood gas analysis. Good agreement between capillary and venous 3-HB measurement was detected by the electrochemical sensor and reference method. Monitoring treatment of DKA revealed a significant correlation between capillary 3-HB and acidosis markers, while no significant correlation was observed between AcAc and acidosis markers. A cut-off value of capillary blood 3-HB >3.8 mmol/L for diagnosis of DKA resulted in 70% and 92% sensitivity and specificity. The electrochemical sensor accurately measures 3-HB concentration in both capillary and venous blood samples, is accurate in diagnosing canine DKA, and appears to reflect the patient's metabolic status during DKA treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Because Taboulet et al 2 found an increased risk of hospitalization for DKA in patients with 3+ or 4+ ketonuria, we selected our outcome variable as presence of 3+ or 4+ ketonuria.…”

Section: Study Protocolmentioning

confidence: 99%

Diagnostic Accuracy of Fingerstick β-Hydroxybutyrate for Ketonuria in Pregnant Women With Nausea and Vomiting

Ferguson

Mullins

2013

Acad Emerg Med

View full text Add to dashboard Cite

Objectives: The aim of this study was to determine whether a rapid, fingerstick b-hydroxybutyrate (b-OHB) test predicts ketonuria in pregnant women with nausea and vomiting.Methods: A convenience sample of 82 pregnant women who presented to the Barnes-Jewish Hospital emergency department (ED) with complaints of nausea or vomiting were enrolled into an institutional review board-approved, prospective, observational study. Exclusion criteria were temperature of >38.3°C, altered mental status, prisoners, and >1 L of any intravenous (IV) fluid before screening. Subjects had fingerstick b-OHB tests, with results reported in increments of 0.1 mmol/L. Urine ketone results were made available once reported as part of standard care and varied from 0 (trace) to +4 values. Ketonuria was defined as a urine ketone value of 3+ or 4+ and was analyzed as a dichotomous, categorical variable. A contingency table and receiver operator characteristic (ROC) curve were constructed for comparing the b-OHB values to those urine ketone values for each patient.Results: Mean (AESD) b-OHB was 0.43 (AE0.52) mmol/L, and median urine was 1+ for the cohort as a whole. The area under the ROC curve equaled 0.95. The sensitivity and specificity for a fingerstick test of >0.45 mmol/L were 89 and 94.5%, respectively. The positive likelihood ratio (LR) was 16, and the negative LR was 0.12.Conclusions: Fingerstick b-OHB is a rapid and reliable diagnostic tool that correlates well with ketonuria and identifies ketonemia in pregnant women with nausea and vomiting. Fingerstick b-OHB testing has the potential to increase triage efficiency, shorten length-of-stay times, and positively affect patient outcomes in an ED setting. (POC) testing of blood b-OHB identifies diabetic ketoacidosis (DKA) urine acetoacetate with equal sensitivity and higher specificity than urine acetoacetate.1,2 Severe nausea and vomiting often results in altered carbohydrate metabolism due to the lack of fluid intake, rather than the inability to utilize available serum glucose, as occurs in DKA.Uncomplicated nausea and vomiting in pregnancy (NVP) affects over 70% of pregnant women. Hyperemesis gravidarum (HG) is the most severe form of NVP and typically includes frequent vomiting, dehydration, electrolyte disturbances, ketonuria, and loss of more than 5% of prepregnancy weight. HG affects 0.5% to 3% of pregnant women, often resulting in ED visits and hospitalizations for parenteral antiemetics and intravenous (IV) fluid replacement. 3,4 Although there is no current single definitive laboratory test to diagnose HG, a clinical presentation of HG, along with a urinalysis showing significant ketonuria, is used to distinguish HG from the larger population of uncomplicated, or mild, NVP. Due to the level of dehydration involved with both HG and mild NVP, however, urine output is often low, which often delays urinalysis detection of acetoacetate and the diagnosis of HG or severe NVP. Effective triage of these patients is important to direct care and resources in the emergency

show abstract

“…The study concluded that either test could be used to exclude ketosis, but that the capillary blood ketone test is more accurate to confirm ketoacidosis. 9 A prospective observational study in an ED comparing ketone dipstick testing with capillary blood ketone testing, showed that the positive likelihood ratio (LR+) for DKA was 3 using urine ketone dipstick testing, and 4 for capillary blood ketone testing. In determining hyperketonaemia (both in diabetic ketosis and diabetic ketoacidosis) the LR+ was 1.8 and 2, respectively.…”

Section: Previous Research Accuracy Compared To Existing Technologymentioning

confidence: 99%

Point-of-care blood test for ketones in patients with diabetes: primary care diagnostic technology update

Plüddemann¹,

Heneghan²,

Price³

et al. 2011

Br J Gen Pract

View full text Add to dashboard Cite

Correlation between urine ketones (acetoacetate) and capillary blood ketones (3-beta-hydroxybutyrate) in hyperglycaemic patients

Cited by 58 publications

References 26 publications

Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis

Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis

Diagnostic Accuracy of Fingerstick β-Hydroxybutyrate for Ketonuria in Pregnant Women With Nausea and Vomiting

Point-of-care blood test for ketones in patients with diabetes: primary care diagnostic technology update

Contact Info

Product

Resources

About