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'''For patient information, click [[Ketoacidosis (patient information)|here]]'''
{{Ketoacidosis}}


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{{SK}} Ketoacidemia.


== [[Ketoacidosis overview|Overview]] ==


==Overview==
== [[Ketoacidosis classification|Classification]] ==
'''Ketoacidosis''' is a type of metabolic [[acidosis]] which is caused by high concentrations of [[ketone bodies]], formed by the [[deamination]] of [[amino acid]]s, and the breakdown of fatty acids. This is most common in untreated type 1 [[diabetes mellitus]], when the liver breaks down [[adipose tissue|fat]] and proteins in response to a perceived need for respiratory substrate. It can also occur with people undergoing hunger strikes, fasting over 3 days, or people starving to death as the body is forced to break down fat for sustenance due to their lack of outside nutrition.


Ketoacidosis should not be confused with [[ketosis]], which is one of the body's normal processes for the metabolism of body fat. In ketoacidosis, the accumulation of keto acids is so severe that the [[pH]] of the [[blood]] is substantially decreased.
== [[Ketoacidosis pathophysiology|Pathophysiology]] ==


==Pathophysiology==
== [[Ketoacidosis causes|Causes]] ==
Ketoacidosis occurs when cells do not have sufficient glucose to meet their metabolic demands.  Instead, [[ketone bodies]] are produced for energy via the [[metabolism]] of [[fatty acids]].


Acidity results from the dissociation of the H<sup>+</sup> ion at physiological pH of metabolic ketone bodies such as [[acetoacetate]], and [[Beta-hydroxybutyrate|β-hydroxybutyrate]]. 
== [[Ketoacidosis differential diagnosis|Differentiating Ketoacidosis from other Diseases]] ==


==Etiology==
== [[Ketoacidosis risk factors|Risk Factors]] ==
Two common causes include [[diabetic]] and [[alcoholic]] ketoacidosis.
== [[Ketoacidosis natural history, complications and prognosis|Natural History, Complications and Prognosis]] ==


In [[diabetic]] patients, ketoacidosis is usually accompanied by [[insulin]] deficiency, [[hyperglycemia]], and [[dehydration]]. Since insulin is required to absorb [[glucose]] from the blood, its deficiency results in an energy crisis, fatty acid metabolism, and production of ketone bodies.  Hyperglycemia results in glucose overloading the nephron and spilling into the [[urine]].  Dehydration results following the osmotic movement of water into [[urine]], exacerbating the [[acidosis]].
== Diagnosis ==


In [[alcoholic]] ketoacidosis, [[alcohol]] causes dehydration and blocks the first step of [[gluconeogenesis]].  The body is unable to synthesize enough glucose to meet its needs, thus creating an energy crisis resulting in [[fatty acid]] metabolism, and [[ketone body]] formation.
[[Ketoacidosis history and symptoms|History and Symptoms]] | [[Ketoacidosis physical examination|Physical Examination]] | [[Ketoacidosis laboratory findings|Laboratory Findings]] | [[Ketoacidosis electrocardiogram|Electrocardiogram]] | [[Ketoacidosis other diagnostic studies|Other Diagnostic Studies]]


== See also ==
== Treatment ==
 
[[Ketoacidosis medical therapy|Medical Therapy]] | [[Ketoacidosis primary prevention|Primary Prevention]] | [[Ketoacidosis secondary prevention|Secondary Prevention]] | [[Ketoacidosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Ketoacidosis future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
 
[[Ketoacidosis case study one|Case #1]]
== Related Chapters ==


* [[Diabetic ketoacidosis]]
* [[Diabetic ketoacidosis]]
* [[Keto acids]]
* [[Keto acids]]
* [[Low-carbohydrate diet]]
* [[Low-carbohydrate diet]]
<br>


== External links ==
* The Merck Manual - [http://www.merck.com/mrkshared/mmanual/section2/chapter13/13b.jsp Diabetic Ketoacidosis]
* [http://www.merck.com/mrkshared/mmanual/section2/chapter13/13c.jsp Alcoholic Ketoacidosis]
*[http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/2878 Lancet case study] Atkins diet-induced Ketoacidosis


[[Category:Medical emergencies]]
[[Category:Medical emergencies]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:diabetes]]
[[Category:Diabetes]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Nephrology]]




Latest revision as of 17:29, 13 February 2013

For patient information, click here

Ketoacidosis Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Ketoacidosis from other Diseases

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Ketoacidemia.

Overview

Classification

Pathophysiology

Causes

Differentiating Ketoacidosis from other Diseases

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Other Diagnostic Studies

Treatment

Medical Therapy | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters



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