Eu- or hypoglycemic ketosis and ketoacidosis in children: a review
The last decade has been characterized by exciting findings on eu- or hypoglycemic ketosis and ketoacidosis. This review emphasizes the following five key points: 1. Since the traditional nitroprusside-glycine dipstick test for urinary ketones is often falsely negative, the blood determination of β-...
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| Veröffentlicht in: | Pediatric nephrology (Berlin, West) West), 2024-04, Vol.39 (4), p.1033-1040 |
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| creator | Meoli, Martina Lava, Sebastiano A. G. Bronz, Gabriel Goeggel-Simonetti, Barbara Simonetti, Giacomo D. Alberti, Ilaria Agostoni, Carlo Bianchetti, Mario G. Scoglio, Martin Vismara, Stefano A. Milani, Gregorio P. |
| description | The last decade has been characterized by exciting findings on eu- or hypoglycemic ketosis and ketoacidosis. This review emphasizes the following five key points: 1. Since the traditional nitroprusside-glycine dipstick test for urinary ketones is often falsely negative, the blood determination of β-hydroxybutyrate, the predominant ketone body, is currently advised for a comprehensive assessment of ketone body status; 2. Fasting and infections predispose to relevant ketosis and ketoacidosis especially in newborns, infants, children 7 years or less of age, and pregnant, parturient, or lactating women; 3. Several forms of carbohydrate restriction (typically less than 20% of the daily caloric intake) are employed to induce ketosis. These ketogenic diets have achieved great interest as antiepileptic treatment, in the management of excessive body weight, diabetes mellitus, and in sport training; 4. Intermittent fasting is more and more popular because it might benefit against cardiovascular diseases, cancers, neurologic disorders, and aging; 5. Gliflozins, a new group of oral antidiabetics inhibiting the renal sodium-glucose transporter 2, are an emerging cause of eu- or hypoglycemic ketosis and ketoacidosis. In conclusion, the role of ketone bodies is increasingly recognized in several clinical conditions. In the context of acid–base balance evaluation, it is advisable to routinely integrate both the assessment of lactic acid and β-hydroxybutyrate. |
| doi_str_mv | 10.1007/s00467-023-06115-5 |
| format | Article |
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G. ; Bronz, Gabriel ; Goeggel-Simonetti, Barbara ; Simonetti, Giacomo D. ; Alberti, Ilaria ; Agostoni, Carlo ; Bianchetti, Mario G. ; Scoglio, Martin ; Vismara, Stefano A. ; Milani, Gregorio P.</creator><creatorcontrib>Meoli, Martina ; Lava, Sebastiano A. G. ; Bronz, Gabriel ; Goeggel-Simonetti, Barbara ; Simonetti, Giacomo D. ; Alberti, Ilaria ; Agostoni, Carlo ; Bianchetti, Mario G. ; Scoglio, Martin ; Vismara, Stefano A. ; Milani, Gregorio P.</creatorcontrib><description>The last decade has been characterized by exciting findings on eu- or hypoglycemic ketosis and ketoacidosis. This review emphasizes the following five key points: 1. Since the traditional nitroprusside-glycine dipstick test for urinary ketones is often falsely negative, the blood determination of β-hydroxybutyrate, the predominant ketone body, is currently advised for a comprehensive assessment of ketone body status; 2. Fasting and infections predispose to relevant ketosis and ketoacidosis especially in newborns, infants, children 7 years or less of age, and pregnant, parturient, or lactating women; 3. Several forms of carbohydrate restriction (typically less than 20% of the daily caloric intake) are employed to induce ketosis. These ketogenic diets have achieved great interest as antiepileptic treatment, in the management of excessive body weight, diabetes mellitus, and in sport training; 4. Intermittent fasting is more and more popular because it might benefit against cardiovascular diseases, cancers, neurologic disorders, and aging; 5. Gliflozins, a new group of oral antidiabetics inhibiting the renal sodium-glucose transporter 2, are an emerging cause of eu- or hypoglycemic ketosis and ketoacidosis. In conclusion, the role of ketone bodies is increasingly recognized in several clinical conditions. In the context of acid–base balance evaluation, it is advisable to routinely integrate both the assessment of lactic acid and β-hydroxybutyrate.</description><identifier>ISSN: 0931-041X</identifier><identifier>EISSN: 1432-198X</identifier><identifier>DOI: 10.1007/s00467-023-06115-5</identifier><identifier>PMID: 37584686</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>3-Hydroxybutyric Acid ; Aging ; Body weight ; Cardiovascular diseases ; Child ; Diabetes mellitus ; Diabetic Ketoacidosis - diagnosis ; Diabetic Ketoacidosis - etiology ; Diabetic Ketoacidosis - therapy ; Fasting ; Female ; Glucose transporter ; Humans ; Hypoglycemia ; Hypoglycemic Agents - adverse effects ; Infant, Newborn ; Ketoacidosis ; Ketone Bodies - urine ; Ketones ; Ketosis ; Ketosis - diagnosis ; Ketosis - etiology ; Ketosis - therapy ; Lactation ; Medicine ; Medicine & Public Health ; Neonates ; Nephrology ; Pediatrics ; Review ; Urology</subject><ispartof>Pediatric nephrology (Berlin, West), 2024-04, Vol.39 (4), p.1033-1040</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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Since the traditional nitroprusside-glycine dipstick test for urinary ketones is often falsely negative, the blood determination of β-hydroxybutyrate, the predominant ketone body, is currently advised for a comprehensive assessment of ketone body status; 2. Fasting and infections predispose to relevant ketosis and ketoacidosis especially in newborns, infants, children 7 years or less of age, and pregnant, parturient, or lactating women; 3. Several forms of carbohydrate restriction (typically less than 20% of the daily caloric intake) are employed to induce ketosis. These ketogenic diets have achieved great interest as antiepileptic treatment, in the management of excessive body weight, diabetes mellitus, and in sport training; 4. Intermittent fasting is more and more popular because it might benefit against cardiovascular diseases, cancers, neurologic disorders, and aging; 5. Gliflozins, a new group of oral antidiabetics inhibiting the renal sodium-glucose transporter 2, are an emerging cause of eu- or hypoglycemic ketosis and ketoacidosis. In conclusion, the role of ketone bodies is increasingly recognized in several clinical conditions. 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G.</au><au>Bronz, Gabriel</au><au>Goeggel-Simonetti, Barbara</au><au>Simonetti, Giacomo D.</au><au>Alberti, Ilaria</au><au>Agostoni, Carlo</au><au>Bianchetti, Mario G.</au><au>Scoglio, Martin</au><au>Vismara, Stefano A.</au><au>Milani, Gregorio P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Eu- or hypoglycemic ketosis and ketoacidosis in children: a review</atitle><jtitle>Pediatric nephrology (Berlin, West)</jtitle><stitle>Pediatr Nephrol</stitle><addtitle>Pediatr Nephrol</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>39</volume><issue>4</issue><spage>1033</spage><epage>1040</epage><pages>1033-1040</pages><issn>0931-041X</issn><eissn>1432-198X</eissn><abstract>The last decade has been characterized by exciting findings on eu- or hypoglycemic ketosis and ketoacidosis. This review emphasizes the following five key points: 1. Since the traditional nitroprusside-glycine dipstick test for urinary ketones is often falsely negative, the blood determination of β-hydroxybutyrate, the predominant ketone body, is currently advised for a comprehensive assessment of ketone body status; 2. Fasting and infections predispose to relevant ketosis and ketoacidosis especially in newborns, infants, children 7 years or less of age, and pregnant, parturient, or lactating women; 3. Several forms of carbohydrate restriction (typically less than 20% of the daily caloric intake) are employed to induce ketosis. These ketogenic diets have achieved great interest as antiepileptic treatment, in the management of excessive body weight, diabetes mellitus, and in sport training; 4. Intermittent fasting is more and more popular because it might benefit against cardiovascular diseases, cancers, neurologic disorders, and aging; 5. Gliflozins, a new group of oral antidiabetics inhibiting the renal sodium-glucose transporter 2, are an emerging cause of eu- or hypoglycemic ketosis and ketoacidosis. In conclusion, the role of ketone bodies is increasingly recognized in several clinical conditions. In the context of acid–base balance evaluation, it is advisable to routinely integrate both the assessment of lactic acid and β-hydroxybutyrate.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37584686</pmid><doi>10.1007/s00467-023-06115-5</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4827-6973</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | 3-Hydroxybutyric Acid Aging Body weight Cardiovascular diseases Child Diabetes mellitus Diabetic Ketoacidosis - diagnosis Diabetic Ketoacidosis - etiology Diabetic Ketoacidosis - therapy Fasting Female Glucose transporter Humans Hypoglycemia Hypoglycemic Agents - adverse effects Infant, Newborn Ketoacidosis Ketone Bodies - urine Ketones Ketosis Ketosis - diagnosis Ketosis - etiology Ketosis - therapy Lactation Medicine Medicine & Public Health Neonates Nephrology Pediatrics Review Urology |
| title | Eu- or hypoglycemic ketosis and ketoacidosis in children: a review |
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