ABSTRACT
Ketosis is an abnormal state of nutrient metabolism that develops when the rate of production of ketones exceeds their removal; as a result, ketones accumulate in body fluids as reflected by high blood and urine levels (1-4). Because ketones are largely organic acids (e.g., b-hydroxybutyric and acetoacetic acid) that dissociate almost completely at the pH of the body fluids, they produce Hþwhich consumes HCO3
and causes metabolic acidosis. Hence the designation of ketoacidosis. The term ketosis is used to describe a mild form of the disturbance, reserving the term ketoacidosis for the full-blown condition that features substantial metabolic acidosis (5).
