Ketoacidosis 537792 224269808 2008-07-08T02:23:26Z Lisasmall 712897 convert inline URL to footnote {{Infobox_Disease | Name = {{PAGENAME}} | Image = | Caption = | DiseasesDB = 29670 | ICD10 = | ICD9 = | ICDO = | OMIM = | MedlinePlus = | eMedicineSubj = med | eMedicineTopic = 102 | MeshID = }} '''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. The two common ketones produced in humans are [[acetoacetic acid]] and [[Beta-hydroxybutyrate|β-hydroxybutyrate]]. 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 can be smelled on a person's breath. This is due to acetone, a direct byproduct of the spontaneous decomposition of acetoacetic acid. It is often described as smelling like fruit or nail polish remover.<REF> [http://www.nlm.nih.gov/medlineplus/ency/article/000320.htm Diabetic ketoacidosis] at medical dictionary of [[National Institutes of Health]].</ref> 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. ==Pathophysiology== 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]]. ==Etiology== Two common causes include [[diabetic]] and [[alcoholic]] ketoacidosis. 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]]. 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. == See also == * [[Diabetic ketoacidosis]] * [[Keto acids]] * [[Low-carbohydrate diet]] == References == <references/> == External links == * The Merck Manual - [http://www.merck.com/mmpe/sec12/ch158/ch158c.html#sec12-ch158-ch158c-1224 Diabetic Ketoacidosis] * [http://www.merck.com/mmpe/sec12/ch158/ch158e.html#sec12-ch158-ch158e-1256Alcoholic Alcoholic Ketoacidosis] *[http://www.medpagetoday.com/PrimaryCare/DietNutrition/tb/2878 Lancet case study] Atkins diet-induced Ketoacidosis [[Category:Medical emergencies]] [[Category:Endocrinology]] [[Category:diabetes]] [[da:Ketoacidose]] [[de:Ketoazidose]] [[et:Ketoatsidoos]] [[fi:Ketoasidoosi]] [[fr:Acidocétose]] [[nl:Keto-acidose]] [[no:Ketoacidosis]] [[pt:Cetoacidose]] [[ro:Cetoacidoză]] [[sl:Ketoacidoza]] [[sv:Ketoacidos]]