Causes of ketosis and ketonuria
- Metabolic abnormalities such as diabetes, renal glycosuria, or glycogen storage disease
- Dietary conditions such as starvation, fasting, high protein, or low carbohydrate diets, prolonged vomiting, and anorexia
- Conditions in which metabolism is increased, such as hyperthyroidism, fever, pregnancy or lactation
In nondiabetic persons, ketonuria may occur during acute illness or severe stress. Approximately 15% of hospitalized patients may have ketonuria, even though they do not have diabetes. In a diabetic patient, ketone bodies in the urine suggest that the patient is not adequately controlled and that adjustments of medication, diet, or both should be made promptly. In the nondiabetic patient, ketonuria reflects a reduced carbohydrate metabolism and excessive fat metabolism.
