Keto Diet: Kidney Stone Risk And Prevention

The ketogenic diet is a low-carb, high-fat diet that has been around since the 1920s as a treatment for epilepsy. Today, it is touted as a remedy for everything from infertility to type 2 diabetes and as a way to lose weight. While the keto diet can be effective for quick weight loss, it is extremely regimented and very difficult to stick to. It also carries some health risks, one of which is kidney stones.

Kidney stones are a well-noted potential side effect of the ketogenic diet. Research has observed that among children following the keto diet as a treatment for epilepsy, 13 out of 195 subjects developed kidney stones. In adults, the estimated incidence of kidney stones in patients on ketogenic diets is 5.9%, with an estimated incidence of 5.8% in children and 7.9% in adults.

The keto diet's focus on high-fat animal foods, such as eggs, meat, and cheese, can lead to a higher risk of kidney stones. This is because a high intake of animal foods can cause your blood and urine to become more acidic, leading to increased excretion of calcium in your urine. Studies also suggest that the keto diet reduces the amount of citrate that is released in your urine, and given that citrate can bind to calcium and prevent the formation of kidney stones, reduced levels of it may also raise your risk of developing them.

Additionally, people with chronic kidney disease should avoid keto, as weakened kidneys may be unable to remove the acid buildup in the blood that results from these animal foods. This can lead to a state of acidosis, which can worsen the progression of chronic kidney disease.

However, it is important to note that not all studies have found a link between the keto diet and kidney stones. One clinical experience reported that kidney stones are rare during a well-formulated ketogenic diet. Furthermore, a study in rats and humans showed that the keto diet has a protective effect against joint damage caused by gout.

Keto diets may cause kidney stones

The ketogenic diet, or keto, is a high-fat, low-carb approach to losing weight. It has been around since the 1920s as a treatment for epilepsy, and today it is also touted as a remedy for everything from infertility to type 2 diabetes.

The Link Between Keto and Kidney Stones

Kidney stones are a well-known side effect of the keto diet in children with epilepsy. In fact, kidney stones are so common that a medication called potassium citrate is sometimes given for prevention.

Research has shown that the keto diet can lead to a drop in urine pH levels, making the most common types of kidney stones more likely. This is due to the diet's restriction of fruits and vegetables, which are a rich source of potassium and citrate, both of which are inhibitors of kidney stones.

The keto diet also tends to be incredibly high in protein, which can increase urine calcium, another risk factor for kidney stones.

Avoiding Kidney Stones on Keto

• Drink plenty of water.
• Eat as many vegetables as possible.
• Keep your sodium intake in check.
• Consider asking your doctor about a potassium citrate prescription.

Healthy Diet to Prevent Kidney Stones

The best way to prevent kidney stones is to eat a well-balanced diet that includes fruits, vegetables, whole grains, healthy fats, and proteins.

• Drink plenty of water.
• Avoid eating more than 2,300 mg of sodium in a day.
• Eat a variety of fruits and vegetables.
• Avoid foods and beverages with a lot of added sugar.

Keto diets can worsen metabolic acidosis

The ketogenic diet is a high-fat, low-carbohydrate, and moderate-protein diet that has been used to treat epilepsy since the 1920s. It is also touted as a remedy for various conditions, including infertility and type 2 diabetes, and as a weight-loss method.

Metabolic Acidosis and the Ketogenic Diet

Metabolic acidosis is a condition in which there is too much acid in the body fluids. It can be caused by various factors, including kidney disease, poison ingestion, and severe dehydration. The ketogenic diet can also contribute to metabolic acidosis due to the production of ketone bodies, which are acidic.

How the Ketogenic Diet Causes Metabolic Acidosis

When the body's primary energy source, glucose, is depleted due to low carbohydrate intake, it switches to burning fat for energy. This process, known as ketosis, results in the production of ketone bodies such as acetoacetate, beta-hydroxybutyrate, and acetone. These ketone bodies are acidic and can cause a decrease in blood pH, leading to metabolic acidosis.

Risk Factors for Metabolic Acidosis on a Ketogenic Diet

Certain individuals may be more prone to developing metabolic acidosis while on a ketogenic diet. These include:

• Children
• Pregnant or lactating women
• Individuals with lower glycogen stores or inherent insulin resistance
• Those with chronic alcoholism, pregnancy, lactation, or diabetes

Preventing and Treating Metabolic Acidosis on a Ketogenic Diet

To prevent metabolic acidosis while on a ketogenic diet, it is recommended to consume a minimum of 100 grams of carbohydrates per day. Eating at least this amount can help avoid ketone body overproduction and the resulting acidosis.

If metabolic acidosis does occur, treatment should focus on halting the ketogenic process by consuming carbohydrates or providing intravenous fluids containing dextrose. Additionally, individuals with underlying conditions that may predispose them to ketoacidosis should avoid ketogenic diets altogether.

While the ketogenic diet has been praised for its potential health benefits, it is important to be aware of the risks associated with it, including metabolic acidosis. By understanding the potential complications and following appropriate guidelines, individuals can make informed decisions about their dietary choices and help mitigate adverse effects.

High-protein keto diets may hasten kidney failure

The ketogenic diet is a high-fat, low-carb approach to weight loss that has become increasingly popular. While it can be effective for quick weight loss, it is extremely regimented and difficult to stick to. The diet typically reduces carbohydrate intake to less than 50 grams per day and calls for a moderately increased intake of protein and fat. On keto, 70% to 80% of calories come from fat, about 20% from protein, and as little as 5% from carbs.

The ketogenic diet has been associated with several health risks and side effects, one of which is kidney stones. Kidney stones are a well-documented potential side effect of the diet, with past research observing that 13 out of 195 children following a keto diet as a treatment for epilepsy developed kidney stones.

The high-protein levels caused by the keto diet could also hasten kidney failure, especially in those with existing kidney disease. The term "ketogenic diet" generally refers to a diet that consists of low carbohydrates, is modest in protein, and high in fat, aimed at inducing ketosis.

In addition to the risks to those with kidney disease, the keto diet may also increase "bad cholesterol" levels and overall chronic disease risk. Furthermore, the source of dietary protein also matters; animal protein has been linked to a higher incidence of kidney injury compared to plant-based protein.

Therefore, it is important for individuals considering the keto diet, especially those at high risk of developing kidney disease, to carefully weigh the potential benefits against the risks.

Keto diets are not recommended for people with kidney disease

The ketogenic diet, or keto, is a high-fat, low-carb approach to eating that has become popular in recent years. While it may be effective for quick weight loss, it is not without its risks. One such risk is the development of kidney stones.

The Link Between Keto and Kidney Stones

Kidney stones are a well-known side effect of the keto diet, particularly in children who follow the diet as a treatment for epilepsy. In fact, kidney stones are so common among this group that a medication called potassium citrate is sometimes prescribed to prevent them.

The keto diet is incredibly restrictive, limiting the consumption of whole grains, fruits, dairy, and some vegetables. This means that the diet is typically lacking in fruits and vegetables, which play a crucial role in kidney stone prevention.

Reasons for the Keto and Kidney Stone Connection

Not Enough Fruits and Vegetables

Fruits and vegetables are alkalizing, helping to neutralize the acid produced by the body during protein metabolism. Excess acid is excreted in the urine, and high levels of urine acid increase the likelihood of kidney stones.

Citrate, found in fruits, is a powerful inhibitor of kidney stones, as it prevents their formation. Low urine citrate is a risk factor for kidney stones.

Potassium, found in fruits and vegetables, is another inhibitor of kidney stones. The more potassium in the diet, the more potassium in the urine, which helps to prevent stones.

Excessive Protein

"Diet culture" keto tends to be incredibly high in protein. This excess protein causes a drop in urine pH, as protein produces acid during metabolism. High urine acid levels make uric acid and calcium oxalate kidney stones more likely.

Excess protein can also increase urine calcium, another risk factor for kidney stones.

Not Enough Calcium

The keto diet typically restricts calcium-rich foods like milk and yogurt, which are key to kidney stone prevention and bone health. Calcium reduces the amount of oxalate absorbed from food.

Possible Changes to Gut Bacteria

Keto and high-fat diets are known to cause changes to the gut bacteria, and these bacteria play a role in kidney stone prevention.

Possible Excess Sodium

"Diet culture" keto diets tend to promote high-sodium foods like cheese, salad dressing, butter, and processed meats. Excess dietary sodium can increase the amount of calcium in the urine, and high urine calcium is the most common cause of kidney stones.

Avoiding Kidney Stones on Keto

If you need to follow a keto diet for medical reasons, there are some steps you can take to help prevent kidney stones:

• Drink plenty of water to ensure you're well-hydrated.
• Eat as many vegetables as possible, focusing on low-carb options.
• Keep your sodium intake in check, limiting it to no more than 2,300 mg per day.
• Consider asking your doctor about a potassium citrate prescription.

While the keto diet may be effective for weight loss, it is not without its risks. The restrictive nature of the diet can lead to nutrient deficiencies and other health issues, including kidney stones. For this reason, it is not recommended for people with kidney disease or a history of kidney stones. If you are considering the keto diet, it is important to consult with a healthcare professional first to ensure it is safe for you.

Keto diets can cause dehydration and constipation

The keto diet is a very high-fat, very low-carb, and moderate-protein eating plan that induces a phenomenon called ketosis. When in ketosis, the body burns fat instead of glucose (usually from carbs) for energy. While the keto diet may help burn fat, it can also cause side effects, many of which are related to the gastrointestinal (GI) tract reacting to the absence of carbs.

Dehydration

The keto diet can cause dehydration. A low-carb diet depletes glycogen stores and lowers insulin levels. Glycogen is the storage form of glucose, and each gram of glycogen is stored with at least three grams of water. As a result, people on the keto diet experience rapid water weight loss and frequent urination. Proper hydration is essential to ensure the body has enough water to maintain normal bowel function.

Constipation

Constipation is another common side effect of the keto diet. The keto diet is typically low in fiber, and individuals following the diet may consume more dairy and drink less water. The combination of these factors can lead to constipation.

The keto diet consists of under 50 grams of carbs per day, mainly fats and protein. Therefore, there is a risk of under-consuming fiber-rich foods. Soluble fiber absorbs water and encourages the movement of food through the digestive tract, while insoluble fiber acts as a bulking agent.

Reducing fiber intake can also alter intestinal microbiota, which is partly responsible for food breakdown. A lack of fiber means up to 50% of people following a keto diet will experience constipation at some point.

Dairy products are allowed on the keto diet, and some people may experience constipation due to lactose, the type of sugar in milk, which can be hard to digest and lead to bloating, gas, nausea, and constipation.

How to Treat and Prevent Keto Constipation

• Add more dietary fiber: Women should aim for around 25 grams of fiber daily, and men should aim for 38 grams. Examples of keto-friendly, fibrous foods include cauliflower, avocado, and almonds.
• Increase water intake: Sufficient hydration is essential to rid the body of waste. Most people should drink between nine and 13 cups of water per day.
• Cut back on dairy: If constipation is suspected, experiment with reducing or avoiding dairy intake.
• Retrain the bowel: Reestablishing frequent bowel movements can help eradicate constipation and improve stool consistency. This may be as simple as drinking enough fluids and establishing a regular time for toilet breaks.
• Add more fat to the diet: Dietary fat serves as an energy source, and healthy fats like monounsaturated fats and omega-3 fatty acids reduce the risk of disease.

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