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Does Keto Cause Kidney Stones

A Concentration Of Acid/salt On A Ketogenic Diet Can Impact Gout

Uric Acid Kidney Stones & Keto Diet Dr. Berg

The concentration of the acid/salt is another contributory factor to gout and kidney stone formation during ketosis.

Think of soluble salt in water. As you add the salt to the water, it dissolves. But as you add more salt, a point will come when the salt no longer dissolves. Its at this point that we say the solution is fully saturated. If you continue to add more salt inside, the crystals will go to the bottom of the solution and precipitate.

Now imagine this occurring in your bloodstream. The undissolved uric acid crystals can accumulate over time and cause an inflammatory response. This mechanism is how gout takes place.

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.

Possible Changes To Gut Bacteria

We know keto and high fat diets cause changes to the community of bacteria that live in our intestines. We are also just beginning to understand that these bacteria play a role in kidney stone prevention.

The impact of a keto diet on the gut microbiome could be yet another reason for the keto kidney stone connection.

Also Check: Why Does Kidney Disease Cause Increased Urination

Manage Your Blood Sugar

People with metabolic syndrome and diabetes have an increased risk of uric acid kidney stones. This is due to a decreased ability to eliminate ammonium which causes your urine to become acidic.

Its believed that insulin resistance is the culprit for this reduced ability to eliminate ammonium. Therefore, managing your blood sugar could be an essential component in kidney stone prevention.

How Cheating On A Ketogenic Diet Increases Uric Acid

Side Effects of Keto Diet: 15 Short &  13 Long Term

However, there is one huge caveat to all this. If you are already susceptible to these diseases, once you are on a ketogenic diet, you cant cheat. Cheating is almost always a surefire way to rapidly up the amount of uric acid in your blood and begin to see those gout symptoms or start creating kidney stones. The most common stories I hear are usually right after a big Holiday and someone eats a lot of Halloween candy or Christmas cookies or after a weekend out on the lake where they have gotten dehydrated and had a few too many beers. Rapidly increasing the amount of fructose you consume in a very short amount of time like that will spike your uric acid levels and increase your risk of a flare up of gout symptoms or kidney stones.

Also Check: How To Ease Kidney Infection Symptoms

Can Keto Diet Cause Kidney Stones

Via Robina Weermeijer / Unsplash

These days, most people use the keto diet to lose weight. No doubt, it is an effective way. As per the modern research, kidney stones on keto are rare, but your diet must be well-formulated. There are several causes of this problem. The most common chemicals which are in these stones of the kidney are uric acid, oxalate, calcium and others.

Due to low dietary magnesium, dehydration, and other genetic factors, people suffer the problem of kidney stones. The level of uric acid level increases during the keto diet. It is due to the less excretion of waste material.

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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Why Do You Get Kidney Stones On Keto

The prime cause of this problem is the high amount of oxalate, protein and calcium in food. The prevalence of renal calculi in consumers on the keto diet is higher as compared to the others.

  • Fat malabsorption,
  • Chronic acidosis and others are the prime reasons for the kidney stones on keto.

It contributes to the formation of calcium oxalate and uric acid stones. As we know, the formation of kidney stones contains many reasons. The most common chemicals are uric acid, oxalate and calcium. This diet is famous for instant weight loss, and it helps with certain medical conditions like Type 2 diabetes and seizures. How long will it be safe to be on keto? If someone follows this diet for an extended period of time, it is hard to avoid its harms.

People on keto use the protein, fat and nuts during the ketogenic diet. It contains ketones in the body to lose weight. This chemical puts a load on the kidneys. So, using a keto diet for a long time is not easy to manage. It can damage human kidneys, liver and other functions. You need to use a well-formulated diet otherwise, you will suffer from this problem on keto.

Via Anh Nguyen / Unsplash

Yes, it does. Some people feel pain in kidneys. Keto puts stress on them, and it gives you kidney stones that cause pain. It is a potential side-effect of the keto diet. This is a low-sugar and high-fat weight loss strategy that puts your body into its natural starvation mode.

Because Keto Severely Limits Carbs You May Develop Nutrient Deficiencies

Ketosis and Kidney Stone Prevention Dr. Berg

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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Don’t Underestimate Your Sweat

Saunas, hot yoga and heavy exercise may be good for your health, but they also may lead to kidney stones. Why? Loss of water through sweating – whether due to these activities or just the heat of summerleads to less urine production. The more you sweat, the less you urinate, which allows for stone-causing minerals to settle and bond in the kidneys and urinary tract.

One of the best measures you can take to avoid kidney stones is to drink plenty of water, leading you to urinate a lot. So, be sure to keep well hydrated, especially when engaging in exercise or activities that cause a lot of sweating.

As Your Body Adjusts To Ketosis Youll Probably Have Bad Breath

Considered a symptom of the keto flu, your breath on this diet often smells fruity at first. This is because acetone is a by-product of ketosis and is eliminated mostly through the lungs and the breath, according to a study in the journal International Journal of Environmental Research and Public Health in February 2014. Acetone is a type of ketone known for having a fruity aroma in smaller concentrations. Its hard to say exactly how long it will last as it depends on the person, but its common for someone to experience this side effect for a few weeks, says Asche.

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Fact Or Fictionprotein Required For Ketosis Can Increase Uric Acid Leading To Gout And Kidney Stone Formation

This hype about protein diets is a common but false misconception.

While its true that a diet containing only whole foods and high fats, like the Atkins diet, might increase uric acid levels, all proteins are not equal.

Our body synthesizes uric acid through the action of the enzyme xanthine oxidase on purines, which are absent in pure proteins. Examples of pure proteins are albumin and protein isolates.

Since the RNA and DNA structures of the cell are made up of purines, one can get a lot of these purine compounds if one takes a lot of cells .

Other foods containing a very high level of purines include fermented foods , red meats, and organ meats . In addition to that, caffeines structure is also similar to that of purine. Hence, uric acid levels can also raise when caffeine is acted upon by the enzyme xanthine oxidase.

On the other hand, an egg being a single cell has a meager amount of purines. As it is a single gamete cell, it only possesses 50% of the chromosomes, and therefore has 50% of the DNA, meaning it contains only 50% of the purines found in a somatic cell.

Note: Albumin, whey isolates, and soy isolates are the primary sources of protein in the Ideal Protein Foods. No purines!

How Does A Ketogenic Diet Affect Kidney Stones

Do Ketones Damage Kidneys

Our clinical experience is that kidney stones are rare during a well-formulated ketogenic diet.

Kidney stones have many causes. The most common chemicals found in kidney stones are calcium, oxalate, and uric acid. Significant promoters of kidney stone formation are genetic factors, dehydration, and low dietary magnesium. Although serum uric acid levels go up in the early adaptation phase of a well-formulated ketogenic diet, this is caused by decreased excretion, not increased production. And after a month or two, the kidneys adapt to maintaining normal uric acid excretion. At Virta, we devote considerable attention to hydration, adequate but not excessive dietary sodium and calcium, and despite plenty of green vegetables, nut, and seeds , we supplement magnesium when there are early clinical signs of depletion.

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Preventing Kidney Stones Generally In 6 Easy Steps

People may prevent kidney stones by changing their intake of liquids and, depending on the kind of kidney stone, by increasing their intake of sodium, animal protein, calcium, and oxalate.

The best way to avoid most types of kidney stones is to drink enough fluids on a daily basis.

Social insurance providers recommend drinking 2 to 3 liters of fluids each day for each person. Drinking a lot more water may be necessary for those who suffer from cystine stones. Even while water is best, other beverages, such as citrus drinks, may also help prevent kidney stones.

Sodium consumption should be limited

The kidneys release more calcium into the urine when exposed to sodium, which is often found in salt. Stones are formed when oxalate and phosphorus combine with excessive urinary calcium excretion.

The goal is to reduce calcium consumption by reducing salt intake. In the United States, the recommended daily allowance for salt is 2,300 milligrams , but the average American intake is closer to 3,400 mg, according to the US Food and Drug Administration . This is why Americans are more likely to develop kidney stones.

Learn how much salt is in your meals to avoid nephrolithiasis, which may cause kidney stones. The salt content in food may be found on the back of the packaging.

Those who are trying to limit their sodium intake, such as checking for fixes and hidden sodium, for example,

Limit the amount of animal protein consumed in your diet.

The Doctors Recommended Way To Go Keto

Chi said that with so many patients asking him to lose weight and feel positive about the diet, he didnt want to deter a helpful-eating move.

I generally tell people, Everything in moderation,’ he said. We try to take a pragmatic approach.

He advises that his patients remain well hydrated and dont overdo it on the meat.

Lemon Water

Shaw added, The weight loss is great and lower carbohydrates are great. But you have to balance that with a high fluid intake so you can wash some of the metabolic products out.

Anything that can help is adding lemon to the bath, said Shaw, since the citrate in the lemon prevents the calcium molecules from binding together.

Children on a keto diet to better manage seizures are often offered oral potassium citrate capsules, all of which may both minimise the amount of stones they produce and prolong the period they take stones to shape.

Recommended Reading: How To Help Kidney Stones Pass Faster

The Relationship Between High Protein Diets And Chronic Kidney Disease

The previous studies show that high-protein diets do not have a negative impact in people who have normal kidney function.

Reduced protein consumption may only be beneficial in patients with advanced chronic kidney disease.

Following a low carbohydrate, adequate protein, high fat diet, can help prevent cardiovascular disease in people with chronic kidney disease.

Since ketosis and protein are not to blame for kidney problems, heres what actually harms your kidneys:

Myth #: Ketones Overwork Your Kidneys Due To Increased Urine Acidity

Relation Between Ketosis & Uric Acid Stones Dr.Berg on Keto Kidney Stones

Theres a common misconception that nutritional ketosis can change the pH of your urine from neutral to acidic and therefore overwork your kidneys.

However, this only happens during ketoacidosis, not ketosis.

Ketoacidosis is a complication that results from dangerously high levels of ketonesand blood sugar, most commonly in people with type I and II diabetes. This combination makes blood too acidic and negatively affects the liver and kidneys.

Ketoacidosis is most likely to occur in people with type 1 diabetes, who cant produce any insulin.

Nutritional ketosis, on the other hand, is different because the level of ketones is in a normal range. When youre in ketosis, you have more ketones in your blood than usual, but not enough to cause ketoacidosis.

The ketogenic diet is all about being in ketosis, not ketoacidosis.

Now that weve debunked those two myths, lets look at why the ketogenic is actually beneficial for your kidneys.

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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.

Adverse Effects Of Ketogentic Diets

The most restrictive ketogenic diets used for epilepsy can cause fatigue, headache, nausea, constipation, hypoglycemia, and acidosis, especially within the first few days to weeks of following the diet . Dehydration, hepatitis, pancreatitis, hypertriglyceridemia, hyperuricemia, hypercholesterolemia, hypomagnesemia, and hyponatremia can also occur .

A study of 300 users of online forums found that self-administered ketogenic diets may be accompanied by a temporary cluster of symptoms frequently termed keto flu, which includes headache, fatigue, nausea, dizziness, brain fog, gastrointestinal discomfort, decreased energy, feeling faint, and heartbeat alterations . In endurance athletes, 3.5 weeks on a ketogenic diet led to unfavorable effects on markers of bone modeling and remodeling .

Longer-term effects can include decreased bone mineral density, nephrolithiasis, cardiomyopathy, anemia, and neuropathy of the optic nerve . Ketogenic diets have low long-term tolerability, and are not sustainable for many individuals . Diets low in carbohydrate have also been associated with an increased risk of all-cause mortality , although recent data suggest that lower-carbohydrate diets can be linked to either higher or lower mortality risk, depending on the quality of the carbohydrate they contain and whether they rely more on animal protein and saturated fat or plant protein and unsaturated fat, respectively .

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May Lead To Nutrient Deficiencies

Since the keto diet restricts several foods, especially nutrient-dense fruits, whole grains, and legumes, it may fail to provide recommended amounts of vitamins and minerals.

In particular, some studies suggest that the keto diet doesnt provide enough calcium, vitamin D, magnesium, and phosphorus .

A study that evaluated the nutrient composition of common diets revealed that very low carb eating patterns like Atkins, which is similar to keto, provided sufficient amounts for only 12 of the 27 vitamins and minerals your body needs to obtain from food .

Over time, this may lead to nutrient deficiencies.

Notably, guidelines for clinicians who manage people on a very low calorie keto diet for weight loss recommend supplementing with potassium, sodium, magnesium, calcium, omega-3 fatty acids, psyllium fiber, and vitamins B, C, and E .

Keep in mind that the nutritional adequacy of this diet depends on the specific foods that you eat. A diet rich in healthy low carb foods, such as avocados, nuts, and non-starchy vegetables, provides more nutrients than processed meats and keto treats.


Some studies suggest that keto provides insufficient vitamins and minerals, including potassium and magnesium. Over time, this could lead to nutrient deficiencies.

Can Keto Cause Kidney Stones

Gout, Kidney Stones, &  the Ketogenic Diet

The keto diet has gained enormous popularity over recent years. It not only helps to shed those extra pounds quickly but also helps with certain health problems like type-2 diabetes and high blood pressure. However, there is a buzz about keto that it causes kidney related issues. If you too have this doubt, check out the below section!

Basically, a ketogenic diet is a diet that puts stress on eating a lot of healthy fats, enough protein and almost negligible carbohydrates. The main goal is to get the required calories from fats and sugar instead of carbs.

The keto diet works by attacking your bodys sugar stores. Hence, your body starts processing fats for energy. The fat breakdown produces ketone molecules which the body uses as fuel. This way your body loses weight by burning down fat.

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