Ask:
Hello, doctor. I just had a health check-up, and my urinalysis results show two values: 1. Ketones: 15 mmol/L and 2. Leukocytes: 500 leu/ml. Could you please advise me on what potential health conditions these results indicate? Are these results dangerous?
Nguyen Thi Ha Giang (1991)
Answer:
Hello. First of all, you should notice that taking urine samples must follow the guidance to ensure the results are free from noise. The urine sample for a complete urinalysis should be collected in the morning, using a midstream urine sample (discard the initial flow), and stored in a clean container. Patients should wash their hands and clean their genital area thoroughly before collecting the sample.
Women who are menstruating may produce false-positive results for parameters such as red blood cells and white blood cells if they do not follow proper sample collection guidelines. In practice, there are cases in which a urinalysis showed 500 leu/ml of white blood cells, but upon taking medical history, the patient had no symptoms of a urinary tract infection. When tested with another sample, the results came back negative. Further inquiry revealed that the patient had either collected the initial urine stream or provided the sample while menstruating.
In your case, the white blood cells 500 leu/ml (equally 3+ level) in the urine is a significant abnormal sign. If you experience symptoms such as painful urination or frequent urination, it may indicate a urinary tract infection. You should consult a Nephrology-Urology specialist to find out the cause of the infection.
Pregnant women, especially in second and third semester usually have white blood cells in the urine. Thus, if you are pregnant, you should consult an obstetric doctor to get advice and treatment. Ketone index is usually meaningless. It is only valued in diabetic patients with uncontrolled high blood glucose levels, and it can lead to the risk of diabetic ketoacidosis coma. In a normal person, especially in children, long-term fasting often causes a slight increase in ketone bodies in blood due to the adaptive mechanism of the body, it also causes ketonuria.
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