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Why Is Creatinine High In Diabetic Ketoacidosis?

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Creatinine Is Falsely Elevated In Diabetic Ketoacidosis Patients: A Comparison Of 4 Jaffe Assays With An Enzymatic Method. Asn Events

Creatinine is Falsely Elevated in Diabetic Ketoacidosis Patients: A Comparison of 4 Jaffe Assays with an Enzymatic Method. ASN Events Creatinine is Falsely Elevated in Diabetic Ketoacidosis Patients: A Comparison of 4 Jaffe Assays with an Enzymatic Method. Azni Abdul-Wahab 1 , Hanh Nguyen 2 , Mervyn Kyi 3 , Wei Ling Chiu 3 , Que Lam Lam 4 , Cherie Chiang 1 3 Pathology/ Endocrinology, Royal Melbourne Hospital, Melbourne Endocrinology, Royal Melbourne Hospital, Melbourne Endocrinology, Austin Hospital , Melbourne Falsely elevatedplasma creatinine due to glucose and ketone interference is well documented inroutine Jaffe assay (1,2). Although Jaffe assays have been recentlystandardised since the introduction of eGFR, the effect of this interference isunknown since the alignment process. Weassessed plasma creatinine in DKA patients using 4 Jaffe assays against anenzymatic method as the gold standard. Samples were collected from DKA patients presenting to the EmergencyDepartment and ten outpatients with normal glucose and bicarbonate.Aliquots were frozen, transported on dry ice, and analysed on 4 Jaffe assays (Architect,Roche, Beckman Coulter and Siemens) and the Vitros Enzymatic assay. Continue reading >>

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  1. yummydaisy

    I am currently nursing my soon to be 3 year old son for his nap and for night-time. I have the dreaded last 5 pounds that I have been unable to loose with exercise. I've not changed my diet because I am still nursing. Is there any research to show if raspberry ketone is safe to take while breast feeding?

  2. cpride

    Dear yummydaisy,
    Because herbal products are not evaluated by the Food and Drug Administration, they often do not have enough research to say they are safe for breastfeeding mothers. We do not know if raspberry ketone is safe for a breastfeeding infant and would not recommend using it while breastfeeding due to the lack of data. Since your child is older and getting minimal amounts of breastmilk, the risk would be less compared to a younger child, but we can not say it is safe.
    Sincerely,
    Cindy Pride, MSN, CPNP
    TTUHSC InfantRisk Center

  3. bilal92

    Raspberry Ketone
    no i wouldn't take anything like that while breastfeeding, any drug you take, your baby takes as well, just stick with the breastfeeding and exercise alone, that's a big calorie burner itself.more about Raspberry Ketone see this site raspberryketonethinfacts dot com

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Spurious Serum Creatinine Elevations In Ketoacidosis

Spurious Serum Creatinine Elevations in Ketoacidosis MARK E. MOLITCH, M.D.; ELISE RODMAN, M.D.; CARL A. HIRSCH, M.D.; ELI DUBINSKY, M.D. Article, Author, and Disclosure Information Author, Article, and Disclosure Information Dr. Molitch is a Clinical Associate of the General Clinical Research Centers program, U.S. Public Health Service (grant RR0054-7). Diabetic ketoacidosis is usually accompanied by dehydration resulting in prerenal azotemia, in which the levels of blood urea nitrogen are elevated out of proportion to those of the serum creatinine (1). In contrast, one patient who had been admitted to our hospital in diabetic ketoacidosis a number of times consistently displayed serum creatinine levels repeatedly elevated out of proportion to her blood urea nitrogen levels but had normal renal function between episodes of ketoacidosis. Investigation showed the elevated creatinine levels to be due to the artifactual interference of acetoacetate in the automated measurement of serum creatinine, a fact not widely Continue reading >>

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  1. saidmusician

    Body Odor and Ketosis

    I feel like I've had much worse body odor lately since doing Keto. This week, especially, my keto strips are reading pretty high, and I woke up today with pretty bad BO. Gross.

  2. skelooth

    I bet my keto BO is worse than yours. I challenge you.... to a duel!

  3. Eileen

    I can often smell myself, but my very candid children say they can't. So it might be my nose as much as my sweat.

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Falsely-elevated Serum Creatinine Values In Diabetic Ketoacidosis -- Clinical Implications.

Falsely-elevated serum creatinine values in diabetic ketoacidosis -- clinical implications. Unusual elevations of serum creatinine (S-CR) out proportion to increases in serum urea nitrogen (S-UN) are frequently observed in patients with diabetic ketoacidosis when S-CR is measured by the Jaffe end-point reaction. This has been ascribed to interference from acetoacetate but this is not however observed with kinetic DuPont ACA methodology. Eighteen patients with diabetic ketoacidosis were studied: SCR measurements were done using the end point Technicon SMA 6/60 method (Group a, 10 patients) or the kinetic DuPont ACA method (Group B, 8 patients). The values for S-CR in Group A patients (mean value and S-D were 3.3 +/- 1.1 mg/dl) were significantly different from Group B patients (1.6 +/- 0.24 mg/dl) (P less than 0.01). A significant positive correlation was obtained between the "excess anion gap" and S-CR in Group A patients (r = + 0.81, p less than 0.01). The results from two patients in whom serial measurements of S-UN, S-CR and the anion gap were carried out further demonstrate the analytical interference. The study demonstrates that in diabetic ketoacidosis elevated creatinine va Continue reading >>

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  1. Celeriac

    Last week, I had a few of MrCeleriac's Ricola sugar-free sweets. I had higher BG but I didn't think that I had kicked myself out of ketosis, but it seems like I did.
    When I did my popcorn experiment in August it was an eye-opening failure, but even with much higher BG for longer, I didn't feel rough. The sweets didn't make much of a blip but I've felt rough, really dehydrated.
    I seem to have the sniffles since last week also, but I'm getting dry mouth, headaches, brain fog. Even though I'm getting better numbers eg 5.1 FBGand 5.5 before lunch today, I just feel so thirsty and er knackered. Does it take a lot of water to get back into ketosis ? Weirdly I'm not gelling yellow cloudy pee etc (sorry for TMI).

  2. Robbity

    @Celeriac, what did the sweets have in them? I think they'd need to be pretty high carb (and the digestible variety rather than the un-digestible sugar alcohol, polyol variety) to really knock and keep you out of ketosis. Have you got any way of testing for ketones to confirm that this has happened? If not get thee to a chemists and get a pack of Ketostix. They're not ideal as they can also not show any ketones if you're well into ketosis and no longer disposing of surplus ones, but may be a guide.
    The best advice I can give is to go very low carb - i.e. max 20g carbs a day (from veggies) and maybe extra fat for a while to be sure you are in ketosis again. Essentially you need to be sure that there are few enough carbs in your body to make it switch (back) to fat burning mode. It's quite possible to go in and out of ketosis over short periods (e.g, over the course of a day) , and you body can also be doing this without a low carb diet and without people necessarily knowing about it - it's a natural process. This switching in and out can happen even if you're well into ketosis, aka "keto adapted", so as a result shouldn't cause any side effects - your body already knows how to do this. I've seen this happening, and my ketone levels certainly can go up and sometimes right down to apparently none, depending on what I've eaten, when I last ate, and what my activity level's been, etc.
    I've never come across anything about requiring water to get you (back) into ketosis, so can't help you with that. But you certainly do need plenty of water, and possbily extra minerals (e.g. salt, potassium) on all low carb diets to replace those you've possibly lost as your kidneys are flushing stuff out at a faster rate.
    Robbity

  3. Celeriac

    Hi @Robbity
    Soo.. bought another meter, because that's actually cheaper than buying the control solution and not showing wild differences to the other one. Have ordered ketostix which I'll pick up from pharmacy tomorrow (they were out of stock).
    The sugar free sweets were the polypol kind. The headaches have gone, I'm not feeling as dehydrated as I was, I don't suppose having sniffles has helped, or the 6.4g poppadum I had last night which kicked me up to nearly 7 very briefly.
    BG has been back in range since Monday despite the poppadum and got 4.8 early evening today.
    Am eating creme fraiche every night to stop liver dumps (works for me) and have had more ghee, coconut oil, palm oil and olive oil. Evian contains magnesium and potassium, I should check whether it adds up to enough with food. I'm considering buying an organic meal replacement powder with loads of vitamins rather than tablets. I'm really unsure that bouillon powder, even organic is that nutritious. The Marigold Engevita nutritional yeast that I mix in with it is tho.
    Don't normally eat carbs which aren't non-starchy veg or dairy. I reckon I don't usually go over 25g but I'll work them out as that's a good idea thanks.
    The sugar free sweets and the poppadum were experiments. I probably should avoid doing them, but if I didn't experiment I wouldn't have discovered that creme fraiche prevents Dawn Phenomenon liver dumps for me - it's the difference between 5.5 and 17.1 !
    I've been eating low carb since 2008 and not experienced the dehydration-thirst thing before but it certainly does seem to have improved a lot this evening. I don't remember ever getting anything like this before.
    I've not used ketostix, here's hoping I don't drop the thing down the loo !

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