Brenda Khan
The ketogenic diet is a popular weight-loss regimen that involves eating meals high in fat and protein but low in carbohydrates. The body is forced to burn fats and use alternative metabolic fuel resources by stimulating endogenous ketone production. While the keto diet has been proven to be effective for weight loss, it has also been linked to several health risks, including kidney damage.
The diet's impact on kidney function has been a subject of debate, with some studies reporting that it can lead to renal impairment and kidney stones, while others suggest it may be safe and effective even for those with mild kidney failure. The standard range of ketones in ketosis is up to 3.00 mmol/L, and exceeding this level can result in serious medical conditions.
Some studies have shown that individuals with chronic kidney disease and those without prior kidney problems have experienced a decline in kidney function after adopting a keto diet. On the other hand, a few studies have found that a very low-calorie ketogenic diet, when conducted under medical supervision, can be safe and effective for weight loss in patients with obesity, even those with mild kidney failure.
The impact of the keto diet on kidney function may depend on various factors, including the presence of underlying kidney disease, diet composition, and individual variations. It is important to consult a healthcare professional before starting any diet, especially those with restrictive nature like the keto diet, to ensure it is safe and appropriate for one's health status.
| Characteristics | Values |
|---|---|
| Effect on kidney function | The keto diet may cause kidney stones and renal failure. However, it is also used to treat kidney disease in obese patients. |
| Effect on people with healthy kidneys | There is no evidence that the keto diet damages the kidneys of healthy people. |
| Effect on people with kidney disease | The keto diet may worsen kidney function in people with kidney disease. |
| Effect on people with early-stage kidney disease | The keto diet may be safe for people with early-stage kidney disease. However, there is conflicting research. |
| Effect on people with advanced kidney disease | The keto diet is not recommended for people with advanced kidney disease. |
What You'll Learn
The keto diet can lead to kidney stones
The keto 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. It is also associated with several potential dangers, including kidney stones.
How kidneys are damaged
Many different diseases, drugs, toxins, and inherited disorders can lead to kidney damage. However, the two most common causes of kidney disease are diabetes and high blood pressure, which damage the kidney's delicate blood vessels and tissues. When the root causes of these two diseases are not addressed, chronic kidney disease and ultimately kidney failure can result.
How the keto diet affects kidney health
The keto diet can put stress on the kidneys and may lead to kidney stones. Kidney stones are a well-noted potential side effect of the diet. Research has shown that among children following a keto diet as a treatment for epilepsy, 13 out of 195 subjects developed kidney stones.
The keto diet can be particularly dangerous for people with kidney disease, as they often need to consume a low-protein diet, which may not align with the type of keto diet being followed.
How to reduce the risk of kidney stones on keto
If you are considering the keto diet, there are several things you can do to minimize the risk of kidney stones:
- Drink plenty of water
- Limit your consumption of high-oxalate foods, such as spinach, avocados, raspberries, and almonds
- Ensure adequate dietary calcium by including foods such as sardines, salmon, and leafy green vegetables in your diet
- Avoid high doses of vitamin C supplements
- Pay attention to adequate mineral supplementation, including magnesium
- Limit your protein intake, especially if you have a history of kidney stones or gout
When to consult a doctor
If you have a history of kidney stones or kidney disease, it is important to consult your doctor before starting the keto diet. They can help you determine if the potential benefits of the diet outweigh the risks for your specific situation.
Additionally, if you experience any prolonged symptoms, such as nausea, while on the keto diet, it is important to seek medical advice.
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The keto diet can worsen metabolic acidosis
Ketogenic diets are typically high in fat, with moderate/low protein and very low carbohydrate content. This type of diet triggers high production of ketone bodies derived from the breakdown of fat to produce energy. Ketone bodies are acidic, and excessive excretion of these acids through the kidneys may cause a decrease in alkaline reserves or bicarbonate ions. As a result, the implication of the ketogenic diet reduced blood pH, leading to ketoacidosis.
Ketoacidosis is a rare condition that can be caused by starvation. Lack of glucose can force the body into ketogenesis, causing a metabolic acidosis. This can be triggered by a diet with low carbohydrate content.
In a study on rats, a long-term ketogenic diet was found to induce metabolic acidosis, with a significant decrease in blood pH. Another study on humans found that a strict low-carbohydrate diet led to ketoacidosis in a non-diabetic lactating woman.
The standard range of ketones in ketosis is up to 3.00 mmol/L, and anything beyond this level can result in serious medical conditions. The most common and easily reversible consequences are constipation, low-grade acidosis, hypoglycemia, kidney stones, and increased lipids in the blood.
It is important to note that ketogenic diets may also have some benefits. They have been used as supportive therapy for epilepsy, diabetes mellitus, and cancer. Additionally, a short-term ketogenic diet may increase the concentration of ketone bodies in the blood and improve the antioxidant capacity of the blood, contributing to reduced oxidative stress.
In summary, while ketogenic diets may offer some health benefits, they can also worsen metabolic acidosis, especially if carbohydrate intake is restricted below 50 grams per day. This can lead to a decrease in blood pH and potentially life-threatening conditions. Therefore, it is important to carefully consider the risks and benefits of ketogenic diets and consult with healthcare professionals before starting such a diet.
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The keto diet may be dangerous for people with kidney disease
The ketogenic (keto) diet has become an increasingly popular way to lose weight. The diet is characterised by very low-carbohydrate, modest protein meals that focus heavily on fat intake. The aim is to induce "ketosis", which generates ketone bodies that serve as an energy source instead of glucose.
However, the keto diet may be dangerous for people with kidney disease. Here are some reasons why:
Kidney Stones
Kidney stones are a well-documented potential side effect of the keto diet. Research has shown that among children following a keto diet to treat epilepsy, 13 out of 195 developed kidney stones. The keto diet can make the urine more acidic and increase calcium and uric acid levels, making people more susceptible to kidney stones.
Stress on the Kidneys
The keto diet can put stress on the kidneys, especially for those with kidney disease. People with kidney disease need to follow an individualized diet prescribed by their doctor, which may include a low-protein diet. The keto diet, on the other hand, often includes high amounts of protein, which can increase the workload on the kidneys and lead to further damage.
Metabolic Acidosis
The keto diet can worsen metabolic acidosis, a common complication of chronic kidney disease. Metabolic acidosis can affect bone and muscle health and further damage kidney function.
High Dietary Acid Load
The high consumption of animal fat and protein associated with the keto diet can lead to albuminuria (losing protein in urine) and the onset of chronic kidney disease. This is because high-protein diets can cause hyperfiltration, which is an increase in blood flow to the filtering unit of the kidney, leading to the progression of chronic kidney disease.
Nutrient Deficiencies
The keto diet severely limits carbohydrates, which can lead to nutrient deficiencies, including fibre and potassium. Fibre is important for regular laxation and supporting the microbiome, while potassium is crucial for electrolyte balance and blood pressure control.
Alternative Diets for Kidney Health
For those with kidney disease, one of the best ways to maintain a healthy weight is to adopt a healthy lifestyle with balanced and portioned meals. This includes adequate amounts of protein, carbohydrates, fat, fibre, and other micronutrients. Restricting salt intake, ensuring proper hydration, and paying attention to foods rich in potassium and phosphorus can also help alleviate stress on the kidneys.
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The keto diet can lead to dehydration and a loss of electrolytes
The keto diet is a high-fat, low-carb approach to eating that has become one of the most popular ways to lose weight. It typically reduces carbohydrate intake to less than 50 grams per day and calls for a moderate increase in protein and fat intake.
Transitioning to a keto diet can lead to dehydration and a loss of electrolytes, which can cause what is known as the "keto flu". This is because, when carbohydrate intake is low, total body water decreases as carbohydrates become depleted. In addition, the brain's favorite fuel is glucose, which is most easily created from carbohydrates. When the body is deprived of this easy fuel source, the brain has to adjust to using ketones from digested fats for energy. This can cause discomfort, and, as insulin levels fall, the kidneys release more electrolytes.
To help your body cope with these symptoms, it is important to drink plenty of water. Symptoms of the keto flu include constipation, nausea, headache, fatigue, irritability, and cramps. These symptoms usually only last a few days to a few weeks. However, if symptoms (especially nausea) are prolonged, it is recommended that you call your doctor.
It is also important to note that, when transitioning to a keto diet, water loss in body tissues can lead to dehydration, which concentrates the urine and the minerals that form kidney stones. Therefore, staying well-hydrated as you start a keto diet is crucial in preventing kidney stones.
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The keto diet can cause constipation
The keto diet involves a significant reduction in carbohydrate intake, with a typical daily allowance of 20-50 grams. Carbohydrates are one of the three main macronutrients, and they include sugar, starch, and fibre, which are present in fruits, vegetables, and grains. The keto diet replaces carbohydrates with high-fat foods and moderate amounts of protein.
Fibre is essential for maintaining regular bowel movements. Soluble fibre absorbs water and encourages food to move through the digestive tract, while insoluble fibre acts as a bulking agent. By reducing fibre intake, the keto diet can lead to constipation, with up to 50% of people following the diet experiencing this side effect.
In addition, dairy products, which are allowed on the keto diet, can also cause constipation. Dairy contains lactose, a sugar that can be difficult to digest and lead to bloating, gas, nausea, and constipation.
Reduced water intake can also contribute to constipation. With fewer fruits and vegetables in the diet, water intake may decrease without a conscious effort to maintain hydration. Dehydration and an imbalance of electrolytes are more prevalent on a keto diet due to the reduction in glycogen, which is stored alongside water in the muscles.
To treat and prevent constipation while on the keto diet, it is recommended to:
- Increase fibre intake by consuming more keto-friendly, high-fibre foods such as non-starchy vegetables, berries, avocados, and nuts.
- Drink plenty of water to stay hydrated.
- Reduce dairy consumption if it is causing digestive issues.
- Exercise regularly, as physical activity can help regulate bowel movements.
- Gradually transition to the keto diet to give your body time to adjust.
- Eat whole, high-fibre foods instead of processed meals and fast food, as these can put extra stress on the digestive system and are typically low in fibre.
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Frequently asked questions
The keto diet is a high-fat, low-carb approach to eating that has become one of the most popular ways to lose weight. The diet typically reduces carbohydrate intake to less than 50 grams per day and calls for moderately increased protein and fat intake.
The keto diet can put stress on the kidneys and may cause kidney stones. The diet can be dangerous for people with kidney disease, as they may need to consume a low-protein diet. However, there is no evidence that the keto diet harms kidney function in people with healthy kidneys.
People with kidney disease, a history of disordered eating, or type 1 diabetes should avoid the keto diet. Pregnant or lactating individuals should also talk to their healthcare provider before starting the keto diet.
For those with kidney disease, one of the best ways to maintain a healthy weight is to adopt a healthy lifestyle with balanced and portioned meals. This includes adequate amounts of protein, carbohydrates, fat, fiber, and other micronutrients. Restricting salt intake and ensuring proper hydration will also alleviate stress on the kidneys.
