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In these conditions, excessive free fatty acid metabolism results in the production of ketoacids, acetoacetic acid, and beta-hydroxybutyrate. Lactic acidosis results from excess formation and decreased metabolism of lactate, which occurs during states of anaerobic metabolism. It is the most common cause of metabolic acidosis in hospitalized ...
Both acetoacetate and beta-hydroxybutyrate are acidic, and, if levels of these ketone bodies are too high, the pH of the blood drops, resulting in ketoacidosis. Ketoacidosis is known to occur in untreated type I diabetes (see diabetic ketoacidosis ) and in alcoholics after prolonged binge-drinking without intake of sufficient carbohydrates (see ...
The supervising clinician can then monitor glucose and beta-hydroxybutyrate levels throughout the course of the fast to generate an understanding of the child's fasting tolerance. [2] If beta-hydroxybutyrate levels continue to excessively rise or remain persistently elevated, additional workup can be performed to detect ketone transporter defects.
β-Hydroxybutyric acid, also known as 3-hydroxybutyric acid or BHB, is an organic compound and a beta hydroxy acid with the chemical formula CH 3 CH(OH)CH 2 CO 2 H; its conjugate base is β-hydroxybutyrate, also known as 3-hydroxybutyrate. β-Hydroxybutyric acid is a chiral compound with two enantiomers: D-β-hydroxybutyric acid and L-β-hydroxybutyric acid.
The resulting very high levels of ketone bodies lower the pH of the blood plasma, which reflexively triggers the kidneys to excrete urine with very high acid levels. The high levels of glucose and ketones in the blood also spill passively into the urine (due to the inability of the renal tubules to reabsorb glucose and ketones from the tubular ...
A high anion gap indicates increased concentrations of unmeasured anions by proxy. Elevated concentrations of unmeasured anions like lactate, beta-hydroxybutyrate, acetoacetate, PO 3− 4, and SO 2− 4, which rise with disease or intoxication, cause loss of HCO − 3 due to bicarbonate's activity as a buffer (without a concurrent increase in ...
An elevated anion gap metabolic acidosis and ketosis is the classic present. [3] However, a mixed acid-base disorder may be present especially if vomiting is contributing to a hypochloremic alkalosis. [2] The ketone which is present is mostly beta-hydroxybutyrate rather than acetoacetate resulting in only a weakly positive nitroprusside test. [2]
When compared with urine acetoacetate testing, capillary blood β-hydroxybutyrate determination can reduce the need for admission, shorten the duration of hospital admission and potentially reduce the costs of hospital care. [36] At very high levels, capillary blood ketone measurement becomes imprecise. [37]