What Are The Dangers Of The Keto Diet
If you are on diabetic medication that causes low blood sugar, those meds may need to be adjusted within a few days, Condon said. There are heart-healthy sources of fat, however if that person is not educated on heart-healthy sources of fat, they may consume excessive amounts of saturated fats that can increase your risk of heart disease, Condon said.
Ketosis Effects On The Kidneys
Very high levels of ketones make your blood more acidic and overburden your kidneys. “Medical News Today” reports that one of the side effects of a ketogenic diet is the formation of kidney stones. In processing higher amounts of protein, your kidneys work hard and are forced to excrete more sodium, calcium and potassium, as well as filter more of the byproducts of protein metabolism. This extra fluid and electrolyte loss can cause low blood pressure, another function mediated by your kidneys. Ketosis in the presence of diabetes can lead to ketoacidosis and coma, and can be life threatening.
The Link Between The Keto Diet & Kidney Stones
The keto diet produces acidosis, so the major effect is expected to be a reduction in urine citrate, said leading nephrologist Dr. David Goldfarb MD. He continued, It will also probably increase the amount of uric acid in the urine, and the acidosis will probably increase the amount of calcium too.
When we asked David for his thoughts on the keto diet, he explained the facts like this:
As the keto diet is very high in animal protein, this will increase the amount of uric acid in the urine which can promote both uric acid stones as well as increased risk for calcium oxalate stones. The increased protein also causes an acid load for the kidneys and promotes bone absorption. The increased acid load will decrease citrate in the urine.
From his feedback, the connection between keto and kidney stones seems pretty straightforward. Keto does increase your risk of kidney stones. Now, while weve talked about the right diet for kidney stone prevention before, weve never deeply explored diets that arent right for kidney stone prevention. After receiving a ton of messages on social media about the keto/kidney stone connection, we decided to dig a little deeper.
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Symptoms Of Kidney Problems
One of the main signs and symptoms you can get from developing kidney problems, is the formation of kidney stones. Kidney stones are the result of the kidneys having nowhere to filter the excess sodium, calcium and potassium created from the kidneys processing protein. These excess substances build up and begin to crystallize and harden to form a kidney stones. The best way to avoid this is to be sure youre not eating too much protein to begin with. Drinking more water and taking a kidney health supplement like Stone Breaker also helps prevent damage by supporting both kidney and gallbladder health . Before beginning the keto diet, always consult your physician to make sure its right for you, and to discuss the concerns you may have with it.
Keto Diet And Kidney Stones
Kidney stones are something to pay attention to prior to starting a keto diet. A case study published in 2010 reviewed a young 5-year-old girl diagnosed with epilepsy. As the ketogenic diet was initially used for epilepsy, the young girl was placed on this diet and monitored by her medical team.
High calcium levels were observed and kidney stone formation was detected just three months into the diet.
Kidney stones are associated with the keto diet as the research has long been studied for children with epilepsy.
An increased prevalence of kidney stones has been found with higher levels of calcium while on the ketogenic diet. However, Potassium citrate is often prescribed in these cases as the ketogenic remains a therapeutic diet for epilepsy.
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Protein And Normally Functioning Kidneys
Why is dietary protein intake sometimes raised as a concern for kidney health? Well, when kidneys are damaged one of the first signs is protein leaking out of the kidney and appearing in the urine. This condition is called proteinuria and it shows that the kidneys filtering system is malfunctioning.
Because of this, some hypothesize that eating too much protein might stress the kidneys and cause proteinuria and kidney damage. And, because people associate low-carb diets with high-protein, this leads some to wonder if low-carb diets lead to proteinuria.
Of course, a well-formulated ketogenic diet is typically not high in protein. Even low-carb diets that arent ketogenic do not necessarily equate with eating large amounts of protein. At Diet Doctor, we recommend most people eat 1.2 2.0 grams of protein for each kilogram of desired body weight which is moderate or adequate protein consumption.
This guide about protein gives lots of examples of what that moderate level of protein could look like in a typical day of eating a low-carb diet:
For the average person on a low-carb diet, there is probably no reason to worry the most credible research available shows that low-carb diets are not associated with kidney damage.7
Ketogenic Diet Causing Kidney Problems Myths Busted
Although in certain contexts it has been suggested that ketogenic diet may lead to renal dysfunction, dedicated research has revealed the weight loss phenomenon which is triggered off by this form of diet has proven to be rather beneficial for the health of the kidneys. Moreover as suggested in a number of contexts ketosis causes a change in the Ph balance of your urine is again not correct. The pH of the urine gets affected due to ketoacidosis and not ketosis. These two are different conditions. Ketoacidosis is a condition that occurs mostly in people suffering from type 1 and 2 diabetes. This condition makes the blood really acidic that adversely affects the kidneys and also the liver. Ketoacidosis is a condition which occurs when the body is unable to produce the required amounts of insulin. In the process of ketosis, the level of ketones in the blood remains within the normal range and does not lead to any damage.
The process of ketosis is quite a normal one and occurs quite naturally to people who do not have access to carbohydrate-rich meals all around the day. Research has proven the fact that the human brain and heart can function better with ketones for energy instead of glucose. Hence, even if you have renal problems keto diet will not affect you adversely.
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Keto Improves Cholesterol Profiles
All cholesterol is not created equal.
High-density lipoprotein also known as good cholesterol is a health marker that many physicians look at to determine the health of their patients, especially those who have chronic kidney disease. An elevation in this type of cholesterol isnt bad for your heart.
However, LDL aka bad cholesterol is a major risk factor for heart disease.
Researchers are now finding that HDL cholesterol and saturated fat shouldnt be to blame for heart disease.
On the other hand, LDL particle size is a more important biomarker to monitor.
One study found that lipid profiles did not predict mortality whereas smaller, LDL particles were linked to a 55% increase in the risk of mortality.
LDL particle size is affected by carbohydrate intake. Abundant carbohydrate consumption triggers the release of LDL.
Meanwhile, a low carb keto diet reduces LDL cholesterol which improves kidney function.
Studies have proven that a low carb, high protein diet can decrease the rate of mortality in people with chronic kidney disease by decreasing LDL, HDL and insulin levels.
Because Keto Severely Limits Carbs You May Develop Nutrient Deficiencies
When carbohydrate intake is low, fiber consumption tends to be low, too. This doesnt come as a surprise when you consider fruits, whole grains, and starchy vegetables are decreased in your diet, says Asche. This can lead to one especially uncomfortable side effect .
Another possible nutrient deficiency: potassium, a mineral important for both electrolyte balance and blood pressure control, notes MedlinePlus. Inadequate intake of potassium is likely when consumption of fruits and starchy vegetables are decreased, says Asche. She recommends adding lower-carb to the diet, including avocado and spinach as well as lower-carb sources of fiber, such as chia seeds and flaxseed .
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What Your Kidneys Do
The kidneys are a pair of bean-shaped, fist-sized organs at the back of your abdomen. Each kidney produces urine that drains to the bladder 24 hours a day. Your kidneys filter large volumes of blood on a continuous basis in order to:
- Remove excess fluid and acids from the body
- Optimally balance fluids, minerals, and electrolytes
- Regulate blood pressure
- Remove waste products, toxins, and drugs
The kidneys also make hormones that help keep your blood and bones healthy, including making calcitriol, the active form of vitamin D.
In short, your kidneys are like the waterworks department of a big city. We cannot survive without functioning kidneys, so we must support them by following a healthy diet and lifestyle.
The Ketogenic Diet Can Improve Kidney Function In Diabetics
Diabetic nephropathy is a condition that occurs as a result of damaged kidneys due to diabetes. It is characterized damage to your glomeruli, the small units within the kidney where blood is filtered.
In short, diabetic nephropathy means your kidneys arent able to filter your blood properly.
Studies have shown that a properly formulated ketogenic diet can help reverse diabetic nephropathy.
Keto can improve this condition due to two main reasons:
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Side Effects Of Keto Diet
Several things can happen when on a keto diet that can be unappealing.
An early onset side effect of the keto diet is called the keto flu. This can include low energy, brain fog and headaches.
For many people, constipation can be a common side effect due to the restriction of carbohydrates. While low-carbohydrate vegetables are a part of a ketogenic diet, many tend to lean towards including more fats like butter and bacon.
Other side effects that can occur from a ketogenic diet include
The diet focuses on high-fat foods and severely restricts the intake of carbohydrate foods, such as fruits, vegetables, legumes, and dairy. Therefore, there is a higher risk for nutritional deficiencies.
Fat-soluble vitamins A and E along with magnesium were also found to be decreased in children following the therapeutic ketogenic diet.
Calcium can also be a problem with the keto diet and kidney disease. The fat sources can lead to metabolic acidosis, which can trigger higher calcium losses in urine. Subsequently, this is why kidney stones can be more prevalent in a keto diet.
To prevent micronutrient deficiencies while following a keto diet for kidney disease, its important to discuss with your dietitian to assess for the appropriate supplement plan.
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Does Keto Cause Kidney Stones
In short, yes. Keto can cause kidney stones. Kidney stones are a well known side effect in children who follow a keto diet for epilepsy. In fact, kidney stones are so common, a medication called potassium citrate is sometimes given for prevention.
Unfortunately, no research has investigated the prevalence of kidney stones in adults who follow a keto diet. So, it is difficult to know how likely kidney stones are in adults on a keto diet. Or, the impact of diet culture keto diets on kidney stones.
I can report that, in my clinical experience, many of my Kidney Stone Nutrition School students and patients can trace their kidney stones back to a keto diet.
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Keto Diet Could Hasten Kidney Failure Says New Research
Research suggests that the keto diet may not be that beneficial for health, obtaining only short-term weight outcomes, and is not more effective then other diets.
How beneficial is the keto diet in reality?
A review in Frontiers in Nutrition has claimed that keto diets place pregnant women and kidney disease patients at risk of adverse health effects, and found that for most people, the possible long-term risks including heart disease, cancer, diabetes, and Alzheimers disease outweigh its possible benefits.
Lead review author Lee Crosby nutrition education program manager at Physicians Committee for Responsible Medicine, described the keto diet as, a disease-promoting disaster.
The review claims that higher-protein levels caused by the keto diet could hasten kidney failure in those with kidney disease, as well as raise bad cholesterol levels.
The term ketogenic diet generally refers to a diet that consists of low carbohydrates, is modest in protein, and high in fat, aimed to induce ketosis.
Keto diets have not only been promoted for weight loss, but though less common for other health reasons, such as seizure disorders, all of which were considered in the review.
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The Potential Dangers Of Ketogenic Diets In Kidney Disease
Higher-protein ketogenic diets may hasten kidney failure and cause other medical problems in patients with kidney disease, according to the most comprehensive review yet of these diets.
Keto diets are low in carbohydrates and high in fat, with disagreement over whether the diets are high in protein, according to study coauthor Shivam Joshi, MD, clinical assistant professor of medicine at the NYU Grossman School of Medicine in New York, New York. The average keto diet consists of 1.2-2.0 g/kg/d of protein, Dr Joshi said, adding that he and his colleagues consider this technically to be a high amount. Supporters of keto diets, however, consider this protein intake to be normal or average, possibly because the typical American diet already consists of 1.2-1.5 g/kg/d of protein, Dr Joshi said.
The review, which was published in Frontiers in Nutrition, demonstrated that the possible long-term risks of the keto diet include heart disease, cancer, diabetes, kidney stones, alzheimer disease, and other diseases.
Keto diets, which can result in ketosis, may be especially unsafe for women who are pregnant or may become pregnant, with strong data suggesting that low-carb diets are linked to a higher risk of neural tube defects in infants even if mothers take folic acid.
Strain on Diseased Kidneys
Impact on Metabolic Acidosis
Keto Diets and Type 1 Diabetes
Ketosis and PKD
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Keto & Kidney Stone Research
According to a study published in June of 2021, the estimated incidence of kidney stones in patients on ketogenic diets is 5.9%. Incidence is approximately 5.8% in children and 7.9% in adults. This study, conducted by a team of diverse doctors, focused on a total of 36 studies with 2795 patients on ketogenic diets. The patients enrolled were tracked for two years and overwhelmingly showed that uric acid stones were the most prevalent kidney stones in patients on ketogenic diets, followed by calcium-based stones.
Avoiding Kidney Stones On Keto
If you need to follow a keto diet for a medical condition, what can you do!? Here are a few tips to help prevent kidney stones on a keto diet:
- Make sure to drink plenty of water. Drinking lots of fluid makes your urine less concentrated, and the chances of a kidney stone less likely.
- Although fruit is off the table, eat as many vegetables as possible. There are many wonderful low carbohydrate vegetables that can fit into a keto diet. Ask your dietitian what is best for you!
- Keep your sodium intake in check. Most people should limit sodium to no more than 2,300mg per day.
- Consider asking your doctor about a potassium citrate prescription.
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The Keto Diet: Helping You Lose Weight Or Hurting Your Kidneys
Weight loss can be a difficult journey. With all the diets, nutrition plans, and weight loss programs out there, its difficult to know whats healthy and backed by science. The ketogenic diet has helped many Americans lose weight however, it may also contribute to an increased decline in kidney function for those with kidney disease.
The Keto Diet is characterized by very low-carbohydrate, modest in protein meals that focus heavily on fat intake. The aim of this diet is to induce Ketosis which generates ketone bodies that serve as an energy source as opposed to glucose. Keto diets have been used in the past especially in children to reduce the frequency of epileptic seizures. These days it has been promoted for weight loss, diabetes management, and liver disease. Research has shown a beneficial effect in short term but the overall long-term effect on health is still unknown.
On the keto diet, your bodys primary source of energy comes from burning fat rather than carbohydrates. Meaning, you arent consuming the vegetables and fruit required in a more traditional diet. Eating more protein and animal fats generates more acid in the blood. Acidosis increases the risk of developing painful kidney stones by lowering urine pH lowering urinary citrate which is protective and increasing urinary calcium excretion.
What This Means For You
Ultimately, you can decide what diet works best for your health goals. If you want to start a keto diet, consider its risks and whether its sustainable for you. Discuss with your doctor or nutritionist about how the dietary plan could affect your health. While keto works for some people to control seizures or lose weight, there are long-term risks that may outweigh any short-term benefits.
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