diabetestalk.net

Ketones In The Urine Kidney Failure

Diabetes Urine Tests

Diabetes Urine Tests

Urine tests may be done in people with diabetes to evaluate severe hyperglycemia (severe high blood sugar) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient insulin to use glucose for energy. Urine tests are also done to look for the presence of protein in the urine, which is a sign of kidney damage. Urine glucose measurements are less reliable than blood glucose measurements and are not used to diagnose diabetes or evaluate treatment for diabetes. They may be used for screening purposes. Testing for ketones is most common in people with type 1 diabetes. Type 1 Diabetes: What Are The Symptoms? This test detects the presence of ketones, which are byproducts of metabolism that form in the presence of severe hyperglycemia (elevated blood sugar). Ketones are formed from fat that is burned by the body when there is insufficient insulin to allow glucose to be used for fuel. When ketones build up to high levels, ketoacidosis (a serious and life-threatening condition) may occur. Ketone testing can be performed both at home and in the clinical laboratory. Ketones can be detected by dipping a test strip into a sample of urine. A color change on the test strip signals the presence of ketones in the urine. Ketones occur most commonly in people with type 1 diabetes, but uncommonly, people with type 2 diabetes may test positive for ketones. The microalbumin test detects microalbumin, a type of protein, in the urine. Protein is present in the urine when there is damage to the kidneys. Since the damage to blood vessels that occurs as a complication of diabetes can lead to kidney problems, the microalbumin test is done to check for damage to the kidneys over time. Can urine tests be used to Continue reading >>

Urine Dipstick Analysis

Urine Dipstick Analysis

Patient professional reference Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Kidney Infection (Pyelonephritis) article more useful, or one of our other health articles. Instructions All samples should be midstream and collected in a clean sterile container. Suprapubic aspiration or fresh catheter samples are ideal, but not always practical. The gold standard method of testing is to remove a small volume of urine from the sterile container with a fresh sterile syringe, and then apply the removed urine to the dipstick. In this way, the remainder of the collected sample contents remains untouched by a potentially unsterile dipstick and so can be sent for laboratory analysis if required. Hold the dipstick horizontally before reading. Available tests include the likes of Multistix® (suitable for screening for glycosuria only), Micral-Test II® or Microalbustix® (detect microalbuminuria) and the more commonly used multiple combination strips - eg, five tests on each strip (detects blood, ketones, glucose, pH and protein), or seven tests on each strip (tests for blood, ketones, glucose, pH, bilirubin, urobilinogen and protein). Costs vary depending on how many substances can be detected and on the supplier. Physical examination Colour The colour of the urine can vary greatly. Normal urine varies from colourless to dark yellow. Various factors can affect urine colour.[1] Common Causes of Urine Discolouration Colour Pathological causes Food and drug causes Brown Bile pigments, myoglobin Levodopa, metronidazole, nitrofurantoin, some antimalarial agents, fava beans Brownish-black Bile pigments, melanin, methaemoglobin Cascara, levodopa, Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious problem that can occur in people with diabetes if their body starts to run out of insulin. This causes harmful substances called ketones to build up in the body, which can be life-threatening if not spotted and treated quickly. DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs. Symptoms of diabetic ketoacidosis Signs of DKA include: needing to pee more than usual being sick breath that smells fruity (like pear drop sweets or nail varnish) deep or fast breathing feeling very tired or sleepy passing out DKA can also cause high blood sugar (hyperglycaemia) and a high level of ketones in your blood or urine, which you can check for using home-testing kits. Symptoms usually develop over 24 hours, but can come on faster. Check your blood sugar and ketone levels Check your blood sugar level if you have symptoms of DKA. If your blood sugar is 11mmol/L or over and you have a blood or urine ketone testing kit, check your ketone level. If you do a blood ketone test: lower than 0.6mmol/L is a normal reading 0.6 to 1.5mmol/L means you're at a slightly increased risk of DKA and should test again in a couple of hours 1.6 to 2.9mmol/L means you're at an increased risk of DKA and should contact your diabetes team or GP as soon as possible 3mmol/L or over means you have a very high risk of DKA and should get medical help immediately If you do a urine ketone test, a result of more than 2+ means there's a high chance you have DKA. When to get medical help Go to your nearest accident and emergency (A&E) department straight away if you think you have DKA, especially if you have a high level of ketones in Continue reading >>

Diabetes Insipidus

Diabetes Insipidus

On this page: What is diabetes insipidus? Diabetes insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid—dilute and odorless. In most people, the kidneys pass about 1 to 2 quarts of urine a day. In people with diabetes insipidus, the kidneys can pass 3 to 20 quarts of urine a day. As a result, a person with diabetes insipidus may feel the need to drink large amounts of liquids. Diabetes insipidus and diabetes mellitus—which includes both type 1 and type 2 diabetes—are unrelated, although both conditions cause frequent urination and constant thirst. Diabetes mellitus causes high blood glucose, or blood sugar, resulting from the body's inability to use blood glucose for energy. People with diabetes insipidus have normal blood glucose levels; however, their kidneys cannot balance fluid in the body. What are the kidneys and what do they do? The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys normally filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. How is fluid regulated in the body? A person's body regulates fluid by balancing liquid intake and removing extra fluid. Thirst usually controls a person’s rate of liquid intake, while urination removes most fluid, although people also lose fluid through sweating, breathing, or diarrhea. The hormone vasopressin, also called antidiuretic hormone, con Continue reading >>

Jardiance® (empagliflozin) Significantly Reduced The Risk Of Progressive Kidney Disease In Adults With Type 2 Diabetes With Established Cardiovascular Disease

Jardiance® (empagliflozin) Significantly Reduced The Risk Of Progressive Kidney Disease In Adults With Type 2 Diabetes With Established Cardiovascular Disease

(empagliflozin) reduced the risk for new-onset or worsening kidney disease by 39 percent versus placebo when added to standard of care in adults with type 2 diabetes with established cardiovascular disease. Boehringer Ingelheim and Eli Lilly and Company (NYSE: LLY) announced today that the findings have been published in The New England Journal of Medicine and also presented at the American Diabetes Association (ADA) 76th Scientific Sessions® in New Orleans. “These findings are clinically important, given that more than a third of people with type 2 diabetes will develop kidney disease, which can lead to kidney failure and eventually the need for dialysis. In the United States, the cost to treat chronic kidney disease is estimated to exceed $48 billion annually,” said Christoph Wanner, M.D., chief of the Division of Nephrology and Hypertension at the University Hospital of Würzburg, Germany. “Since diabetes is the number one cause of kidney failure in the U.S., novel treatments that may have the potential to help address this crucial medical need are necessary.” These findings were part of a pre-specified exploratory analysis plan of additional endpoints of the landmark EMPA-REG OUTCOME® trial. New-onset or worsening kidney disease was a pre-specified composite endpoint that included the below clinical events. Compared with placebo, JARDIANCE led to the following statistically significant changes in outcomes: 55 percent reduction in the initiation of renal replacement therapy (such as dialysis) 44 percent reduction in doubling of creatinine (a waste product usually filtered by the kidneys) in the blood 38 percent reduction in progression to macroalbuminuria (very high levels of a protein called albumin in the urine) JARDIANCE also significantly slowed the dec Continue reading >>

Ketones

Ketones

By-products formed when the body breaks down fat for energy. When the body is starved of glucose or, as in the case of Type 1 diabetes, does not have enough insulin to use the glucose that is in the bloodstream, it begins breaking down fat reserves for energy. Unlike glucose, which “burns clean,” the breakdown of fat creates potentially toxic by-products called ketones, which accumulate in the blood. An excessive amount of ketones in the blood is called ketosis. When the kidneys filter ketones into the urine, the condition is called ketonuria and can be detected by urine ketone tests. If enough ketones accumulate in the blood, they can cause a potentially life-threatening chemical imbalance known as ketoacidosis. The symptoms of ketoacidosis include nausea, vomiting, tiredness, frequent urination, and a fruity odor to the breath. Anyone with symptoms of ketoacidosis should seek medical help immediately. Ketoacidosis is often what causes people to first be diagnosed with Type 1 diabetes: Beta cells in the pancreas stop making enough insulin, thus preventing body cells from getting energy in the form of glucose. The body responds by burning fats for fuel, creating an excess of ketones in the blood. As dehydration also sets in, the person develops ketoacidosis. The nausea and vomiting that accompany ketoacidosis are sometimes mistaken for the symptoms of a bad flu. People with diabetes, particularly those with Type 1 diabetes, are at increased risk of ketoacidosis when they are sick. The stress of illness tends to raise blood glucose levels. But since illness often decreases a person’s appetite, resulting in less food intake than usual, some people mistakenly decrease their insulin dosages. In fact, increased amounts of insulin are often needed when a person is sick. Continue reading >>

Clearing Up Kidney Confusion: Part Deux

Clearing Up Kidney Confusion: Part Deux

It’s funny how our mental state really affects how we write and what we are interested in. When I wrote the introduction to this piece I was just getting settled into our new place in Santa Fe, NM and was looking at over a month at home to work and write. Then a number of wacky events happened and I’ve been home about 7 days out of the last month and I’ve only made it about 70 pages into Kon-Tiki. Ouch. Now I’m home for 8 days and will then be gone for a project that will take me completely off the grid for nearly 3 weeks. No phone, email…nada. When I sat down to do this kidney piece it was with a mindset that I had a ton of time and could really sink my teeth into it. Now I’m time crunched and anxious that I will get it done at all! Up front here I’d like to thank Mat “The Kraken” Lalonde with his help on some literature for this piece. Any inaccuracies however are my own tomfoolery. If I wanted to cut to the chase I could boil this whole thing down to the following: 1-Dietary protein DOES NOT CAUSE KIDNEY DAMAGE. 2-Chronically elevated BLOOD GLUCOSE levels DO cause kidney damage. 3-Dietary fructose REALLY causes kidney damage. 4-Many kidney issues have either a hyperinsulinemic characteristic, an autoimmune characteristic, and or a combination of autoimmunity or hyperinsulinism. A standard, low-ish carb paleo diet can fix most of these issues. 5-For serious kidney damage a low-protein, ketogenic diet can be remarkably therapeutic. 6-If you get kidney stones that are from oxalates, reduce your green veggie intake (spinach for example) and have other types of veggies. 7-If you get kidney stones that are from urate salts, you are likely NOT following a low-ish carb paleo diet, you likely have insulin resistance and your liver is not processing uric acid Continue reading >>

Ketosis: Symptoms, Signs & More

Ketosis: Symptoms, Signs & More

Every cell in your body needs energy to survive. Most of the time, you create energy from the sugar (glucose) in your bloodstream. Insulin helps regulate glucose levels in the blood and stimulate the absorption of glucose by the cells in your body. If you don’t have enough glucose or insufficient insulin to get the job done, your body will break down fat instead for energy. This supply of fat is an alternative energy source that keeps you from starvation. When you break down fat, you produce a compound called a ketone body. This process is called ketosis. Insulin is required by your cells in order to use the glucose in your blood, but ketones do not require insulin. The ketones that don’t get used for energy pass through your kidneys and out through your urine. Ketosis is most likely to occur in people who have diabetes, a condition in which the body produces little or no insulin. Ketosis and Ketoacidosis: What You Need To Know Ketosis simply means that your body is producing ketone bodies. You’re burning fat instead of glucose. Ketosis isn’t necessarily harmful to your health. If you don’t have diabetes and you maintain a healthy diet, it’s unlikely to be a problem. While ketosis itself isn’t particularly dangerous, it’s definitely something to keep an eye on, especially if you have diabetes. Ketosis can be a precursor to ketoacidosis, also known as diabetic ketoacidosis. Ketoacidosis is a condition in which you have both high glucose and high ketone levels. Having ketoacidosis results in your blood becoming too acidic. It’s more common for those with type 1 diabetes rather than type 2. Once symptoms of ketoacidosis begin, they can escalate very quickly. Symptoms include: breath that smells fruity or like nail polish or nail polish remover rapid breat Continue reading >>

Diabetes With Ketone Bodies In Cats

Diabetes With Ketone Bodies In Cats

Diabetic ketoacidosis is an extreme medical emergency that requires immediate veterinary attention. The condition can result in an accumulation of fluid in the brain and lungs, renal failure or heart failure. Affected animals that are not treated are likely to die. With timely intervention and proper treatment, it is likely that an affected cat can recover with little to no side effects. Diabetes mellitus occurs when the pancreas fails to produce sufficient insulin, creating an inability to efficiently process the sugars, fats, and proteins needed for energy. The resulting build-up of sugar causes extreme thirst and frequent urination. Since sugar levels help to control appetite, affected animals may experience a spike in hunger and lose weight at the same time due to the inability to properly process nutrients. In extreme cases, diabetes may be accompanied by a condition known as ketoacidosis. This is a serious ailment that causes energy crisis and abnormal blood-acid levels in affected pets. Cats affected with diabetic ketoacidosis are likely to present with one or more of the following symptoms: Vomiting Weakness Lethargy Depression Excessive Thirst Refusal to drink water Refusal to eat Sudden weight loss Loss of muscle tone Increased urination Dehydration Rough coat Dandruff Rapid breathing Sweet-smelling breath Jaundice The exact cause of diabetes in cats is unknown, but it is often accompanied by obesity, chronic pancreatitis, hormonal disease, or the use of corticosteroids like Prednisone. Ketoacidosis, the buildup of ketone waste products in the blood that occurs when the body burns fat and protein for energy instead of using glucose, is caused by insulin-dependent diabetes. Diabetic ketoacidosis is commonly preceded by other conditions including: Stress Surgery Continue reading >>

Urinalysis And Urine Culture

Urinalysis And Urine Culture

Urinalysis is testing of the urine. A urine sample is usually collected using the clean-catch method or another sterile method. For example, a method to obtain an uncontaminated urine sample involves passing a catheter through the urethra into the bladder. Urine cultures, in which bacteria from a urine sample are grown in a laboratory, are done to diagnose a urinary tract infection. Cultures are not part of routine urinalysis. The sample of urine must be obtained by the clean-catch method (see Obtaining a Clean-Catch Urine Sample) or by briefly inserting a sterile catheter through the urethra into the bladder. Urinalysis can be used to detect and measure the level of various substances in the urine, including protein, glucose (sugar), ketones, blood, and other substances. These tests use a thin strip of plastic (dipstick) impregnated with chemicals that react with substances in the urine and quickly change color. Sometimes the test results are confirmed with more sophisticated and accurate laboratory analysis of the urine. The urine may be examined under a microscope to check for the presence of red and white blood cells, crystals, and casts (impressions of the kidney tubules created when urinary cells, protein, or both precipitate out in the tubules and are passed in the urine). Protein in the urine (proteinuria) can usually be detected by dipstick when present in large amounts. Protein may appear constantly or only intermittently in the urine, depending on the cause. Proteinuria may occur normally after strenuous exercise, such as marathon running, but is usually a sign of a kidney disorder. Small amounts of protein in the urine may be an early sign of kidney damage due to diabetes. Such small amounts may not be detected by dipstick. In these cases, urine will need to Continue reading >>

What Is Urinalysis?

What Is Urinalysis?

Urinalysis is a series of tests on your pee. Doctors use it to check for signs of common conditions or diseases. Other names for it are urine test, urine analysis and UA. You may have a urinalysis as part of a routine check of your overall health, for instance as part of an annual physical. Urinalysis is one way to find certain illnesses in their earlier stages. They include: Your doctor may also want to test your pee if you’re getting ready to have surgery or are about to be admitted to the hospital. Urinalysis can be part of a pregnancy checkup, too. If you have symptoms of a kidney or urinary tract problem, you may have the tests to help find out what the problem is. Those symptoms include: Pain in your belly Pain in your back Pain when you pee or needing to go frequently You might also have this test regularly if you have a condition such as a kidney disease that needs to be watched over time. There are three different ways to analyze urine, and your test might use all of them. One is a visual exam, which checks the color and clarity. If your pee has blood in it, it might be red or dark brown. Foam can be a sign of kidney disease, while cloudy urine may mean you have an infection. A microscopic exam checks for things too small to be seen otherwise. Some of the things that shouldn’t be in your urine that a microscope can find include: Red blood cells White blood cells Bacteria Crystals (clumps of minerals – a possible sign of kidney stones) The third part of urinalysis is the dipstick test, which uses a thin plastic strip treated with chemicals. It’s dipped into your urine, and the chemicals on the stick react and change color if levels are above normal. Things the dipstick test can check for include: Acidity, or pH. If the acid is above normal, you could hav Continue reading >>

Lupus And Kidney Disease: What You Should Know About Lupus Nephritis (lupus Kidney Disease)

Lupus And Kidney Disease: What You Should Know About Lupus Nephritis (lupus Kidney Disease)

Adapted from a presentation at the SLE Workshop at Hospital for Special Surgery Introduction At this session of the SLE Workshop at HSS, Dr. Kyriakos Kirou presented his expertise on the diagnosis, symptoms, treatments, and research related to lupus and kidney involvement, including lupus nephritis (LN). Dr. Kirou is an assistant attending physician at HSS and the co-director of the Mary Kirkland Center for Lupus Care. When presenting, Dr. Kirou emphasized that the purpose of his presentation is to educate patients about lupus and its interaction with the kidney and should not be used as therapeutic advice. He stressed that when patients need to make a decision about their own specific care, they should consult their own rheumatologist. It is important to recognize that there’s no “one fits all” therapy. Dr. Kirou discussed how lupus can affect the kidney and cause the disease known as lupus nephritis (LN). He also discussed tests that are used for diagnosis, as well as available therapies. He also spoke about the necessary lifestyle changes that LN patients may have to adopt after their diagnosis of LN to minimize harm in their bodies. First, it is important to understand how the kidney functions, what happens when someone with lupus has problems with their kidneys, and how they can go about dealing with the situation. Background Information Lupus:Lupus is a chronic and autoimmune disease that affects several parts of the body, including joints, blood, skin, and kidneys. The immune system of those with lupus does not function properly. Lupus creates autoantibodies that fight and damage the cells, tissues, and body organs. When they are present, they can likely lead to disease. Kidney: The kidney is a bean-shaped, fist-sized organ that helps cleans the body from a Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

As fat is broken down, acids called ketones build up in the blood and urine. In high levels, ketones are poisonous. This condition is known as ketoacidosis. Diabetic ketoacidosis (DKA) is sometimes the first sign of type 1 diabetes in people who have not yet been diagnosed. It can also occur in someone who has already been diagnosed with type 1 diabetes. Infection, injury, a serious illness, missing doses of insulin shots, or surgery can lead to DKA in people with type 1 diabetes. People with type 2 diabetes can also develop DKA, but it is less common. It is usually triggered by uncontrolled blood sugar, missing doses of medicines, or a severe illness. Continue reading >>

Abnormal Contents Of Urine

Abnormal Contents Of Urine

Normally, urine contains water and wastes, such as urea, uric acid, creatinine, and some ions. However, some of these substances may be abnormally elevated, which usually indicates that something is wrong with the body. The following are some of the abnormal constituents of urine and some possible causes. Albumin Albumin is a type of protein, which is a normal component of plasma—the fluid component of blood. When albumin is found to be excessive in the urine, it may indicate that the tiny filtering units in the kidney, called nephrons, are damaged or destroyed. Elevated albumin in the urine is termed albuminuria. Bilrubin Bilirubin, when modified by the kidneys, contributes to the classical yellow color of urine. It is a byproduct that results from the breakdown of hemoglobin—the red pigment in red blood cells. When levels of bilirubin in urine is above normal, the condition is called bilirubinuria. This may indicate liver disease or obstructive biliary disease. Glucose The presence of glucose or blood sugar in urine is called glucosuria. It may indicate that the person has diabetes. Ketone bodies The presence of ketone bodies in the urine may indicate diabetes or anorexia. It may also be elevated during fasting and starvation. Microbes The presence of microorganisms, such as bacteria or fungus may indicate urinary tract infection. Blood The red blood cells in blood should not be found in urine because they are too large to pass through the nephrons. Hematuria is the clinical term used when red blood cells are present in the urine. It may indicate damage to the kidney, such as in renal or kidney disease. Sometimes, blood may be present because of the presence of kidney stones. White blood cells When white blood cells are present in the urine, it may indicate infect Continue reading >>

Dr. Oz Explains Symptoms Of Chronic Kidney Disease

Dr. Oz Explains Symptoms Of Chronic Kidney Disease

There's a dangerous health problem on the rise in the United States, affecting more than 20 million adults—25 percent more than a decade ago. It's more common than diabetes and twice as prevalent as cancer. More alarming: New evidence shows that the majority of those stricken by the condition don't even know they have it. What is this insidious epidemic? Chronic kidney disease. Located just below the rib cage on either side of the spine, the kidneys act like a laundry service for your blood. Each bean-shaped organ, about the size of a computer mouse, contains approximately one million tiny filters, or nephrons, that separate the nutrients and other substances your body needs from waste products and excess fluid, which you eliminate as urine. Chronic kidney disease (CKD) occurs when the organs' tiny filters are progressively damaged over the course of several months to years. Eventually the damage leads to a dangerous buildup of waste in your blood, which can cause inflammation in the blood vessels, setting you up for heart attack, stroke, even brain damage. Without treatment to help slow the progress of the disease, many patients will require either dialysis or a kidney transplant. One reason CKD is on the rise is that it's linked to two other increasingly common conditions—diabetes and hypertension, which together account for two-thirds of CKD cases. (High blood sugar and high blood pressure damage the kidney's nephrons and impair blood vessel function, making it more difficult for waste to be removed.) But although more and more Americans are being screened for these two conditions, CKD often goes undiscovered until obvious symptoms—such as numbness in the hands or feet, a halt to menstruation, or severe joint pain—appear. The bad news: These symptoms usually Continue reading >>

More in ketosis