Lab Test: Ketones (Serum) Level
- Measurement of serum or plasma ketones, specifically acetoacetate, for analysis of ketone-producing glycogenolytic disorders
- Initial evaluation of suspected hyperglycemic hyperosmolar state (HHS)
- Serum ketones are sometimes low in HHS.
- Suspected alcoholic ketoacidosis (AKA)
- Elevated serum ketones in a patient with a history consistent with alcoholic ketoacidosis.
- Suspected and known diabetic ketoacidosis (DKA)
- Positive serum ketones are part of the diagnostic criteria for mild, moderate, and severe diabetic ketoacidosis (DKA).
- Ketonemia usually takes longer to clear than hyperglycemia does.
- The nitroprusside reaction is a semi-quantitative test that detects only acetoacetate and acetone.
- The predominant ketone formed by ketogenesis is beta-hydroxybutyrate.
- Test results should be interpreted with caution, as acetoacetate levels alone may not accurately reflect serum ketone levels at diagnosis or during the treatment of DKA.
- Cover specimen and transport immediately to laboratory.
- Avoid hemolysis.
- If analysis is not performed immediately, freeze specimen at -80°C to avoid significant acetoacetate degradation and false results.
- Foreback CC. B-hydroxybutyrate and acetoacetate levels. Am J Clin Pathol 1997;108:602-4.
- LaGow B et al., eds. PDR Lab Advisor. A Comprehensive Point-of-Care Guide for Over 600 Lab Tests. First ed. Montvale, NJ: Thomson PDR; 2007.
- Porter WH et al. Laboratory and clinical evaluation of assays for B-hydroxybutyrate. Am J Clin Pathol 1997;107:353-8.
Indications & Uses
Storage and Handling
MESH Terms & Keywords