Ketoacidosis
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Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch. Ketoacidosis is a type of metabolic acidosis which is caused by high concentrations of ketone bodies, formed by the deamination of amino acids, and the breakdown of fatty acids. This is most common in untreated type 1 diabetes mellitus, when the liver breaks down 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.
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+ ion at physiological pH of metabolic ketone bodies such as acetoacetate, and 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
External links
- The Merck Manual - Diabetic Ketoacidosis
- Alcoholic Ketoacidosis
- Lancet case study Atkins diet-induced Ketoacidosis
de:Ketoazidose fi:Ketoasidoosisv:Ketoacidos
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
