The value of the capillary blood ketone measurement in rating of dehydration: An experimental study

The value of the capillary blood ketone measurement in rating of dehydration: An experimental study

Aim: In this study, we aimed to determine the value of blood ketone levels in diagnosing and classifying dehydration.Material and Methods: A total of 40 rats were included into the study. Rats were categorized into four groups according to their weight loss: control group (no weight loss), mild dehydration group (3 – 5% weight loss), moderate dehydration group (5 – 10% weight loss) and severe dehydration group (>10% weight loss). The blood samples taken from the rats were analyzed for capillary blood ketone levels, venous blood ketone levels and the other biochemical parameters.Results: There was no significant difference between four study groups according to the venous blood ketone levels and capillary ketone levels. Only Na levels were significantly different between study groups among all the metabolic parameters. (p=0.044). After categorizing the study groups as control and dehydration groups according to the weight loss, a borderline significance was established for Na (146±6 vs 151±2.5; difference: 4.2 mmol/L, %95 CI: -0.2 to 8.6, respectively; p=0.06) and capillary blood ketone (0.4 (IQR:0.3-0.5) vs 0.6 (IQR:0.4-0.7), respectively; p=0.097), while other parameters did not differ significantly. The capillary blood ketone had a sensitivity of 96.7% (95% CI: 82.8 -99.9), specificity of 10% (95% CI: 0.3-44.5) for detecting dehydration.Conclusions: This study showed that there was no significant difference for the development of ketosis in dehydration. However, the borderline significance for the capillary ketone levels indicates the necessity of human studies.

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  • 1. Khan MI, Dellinger RP, Waguespack SG. Electrolyte Disturbances in Critically Ill Cancer Patients: An Endocrine Perspective. J Intensive Care Med 2018;33:147-58.
  • 2. Guastaferro R, Rosi IM, Milos R, et al. Development of a screening tool to assess dehydration in hospitalized older population: a diagnostic, observational study. Prof Inferm 2018;71:178-87.
  • 3. Fortes MB, Owen JA, Raymond-Barker P, et al. Is this elderly patient dehydrated? Diagnostic accuracy of hydration assessment using physicalsigns, urine,and saliva markers.J Am Med Dir Assoc 2015;16:221-8.
  • 4 Friedman JN, Goldman RD, Srivastava R, et al. Development of a clinical dehydration scale for use in children between 1 and 36 months of age. J Pediatr 2004;145:201-7.
  • 5. Barkin RM, Ward DG. Infectious Diarrheal Disease and Dehydration. In: Editor-in-chief John A, Marx. Rosen’s Emergency Medicine, concepts and clinical practice. Vol 3. Philadelphia: Elsevier; 2006:2623-35.
  • 6. Hooper L, Bunn DK, Abdelhamid A, et al. Water-loss (intracellular) dehydration assessed using urinary tests:how well do they work? Diagnostic accuracy in older people. Am J Clin Nutr 2016;104:121-31.
  • 7. Yilmaz K, Karabocuoglu M, Citak A, et al. Evaluation of laboratory tests in dehydrated children with acute gastroenteritis. J Paediatr Child Health 2002;38:226-8.
  • 8. Cotter DG, Ercal B, d’Avignon DA, et al. Impairments of hepatic gluconeogenesis and ketogenesis in PPARα-deficient neonatal mice. Am J Physiol Endocrinol Metab 2014;307:176-85.
  • 9. Puchalska P, Crawford PA. Multi-dimensional roles of ketone bodies in fuel metabolism, signaling, and therapeutics. Cell Metab 2017;25:262-84.
  • 10. Newton CA, Raskin P. Diabetic ketoacidosis in type 1 and type 2 diabetes mellitus: clinical and biochemical differences. Arch Intern Med 2004;164:1925-31.
  • 11. Byrne HA, Tieszen KL, Hollis S, et al. Evaluation of an electrochemical sensor for measuring blood ketones. Diabetes Care 2000;23:500-3.
  • 12. Bektas F, Eray O, Sari R, et al. Point of care blood ketone testing of diabetic patients in the emergency department. Endocr Res 2004;30:395-402.