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** There is also a time delay if the blood levels are changing, this will not be reflected in the urine levels immediately<ref name="Laffel-1999"/>.
** A study indicated that the level of urine AcAc and blood AcAc vary in a non-linear manner, following the equation "y = 0.3x<sup>0.6</sup> + 0.07" (after correction), but r<sup>2</sup> was only 0.59 <ref name="Musa-Veloso-2002"/>. [[File:KetoneAcAcUrineBlood.jpg|none|thumb|300px|The levels of AcAc in the blood and urine follow a non-linear relationship.]]
* Further problems arise because the levels of AcAc can be quite different to BOHB levels, as shown below. A study of children using the Ketogenic Diet for epilepsy showed that when blood BOHB levels are over 2 mmol/l, urine AcAc dipsticks indicate levels of 80-160 mmol/l<ref name="Gilbert-2000"/>.�[[File:KetonesProgressiveStarvation.jpg|none|thumb|300px|Changes in blood ketone levels during progressive starvation<ref name="Cahill2006"/>.]]
* Finally, false positives can occur for a number of reasons.
** Pigmented urine<ref name="patient.co.uk"/> (trace level only).
