Keto Diet And Stage 3 Kidney Disease
For stage 3 kidney disease and earlier, the keto diet may show some promise.
One study had 92 patients with an average BMI of 33.8 follow a very-low-calorie ketogenic diet. The diet included 450-800 calories per day with a high protein intake of 1.0-1.4 grams per kilogram of body weight. The diet protocol lasted for approximately 15 weeks.
Of the 92 participants in this study, 38 were classified as early CKD stage 2. The creatinine in this group was stable.
Some of the participants reported full recovery of kidney function. The authors, however, also acknowledged that several factors, including the weight loss itself, as a factor of the change in kidney function.
The study also emphasized the importance of the diet as a medically supervised diet. This is due to the intense level of progress monitoring to prevent deficiencies and potentially exacerbate any health issues.
Saturated Fat Is Not Harmful Its Beneficial
People have been led to believe that saturated fats are the reason for higher mortality and heart disease.
This is why many folks think that eating lots of meat on keto is bad for the kidneys and the heart. It was told that eating meat products high in fat, and red meat would be harmful to our health.
This is not correct. Unprocessed meat will not greatly increase the risk of cardiovascular disease, but processed meat poses a risk.
Processed meats are not recommended on keto. Processed meats increase your risk of heart disease by 70%. Stay with grass-fed meats for better heart health.
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Is The Keto Diet Safe
The keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease. Strict diets like keto could also cause social isolation or disordered eating. Keto is not safe for those with any conditions involving their pancreas, liver, thyroid or gallbladder.
Kleinman said someone new to the keto diet can also experience whats called the keto flu with symptoms like upset stomach, dizziness, decreased energy, and mood swings caused by your body adapting to ketosis.
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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
Nutritional Deficiencies
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.
These deficiencies can include B vitamins , calcium , vitamin D, and electrolytes like potassium.
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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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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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.
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Keto Diet And Kidney Disease
Keto Diet And Kidney Disease Does It Help? And Dangers
Today were talking about the keto diet and kidney disease from one of the first major published journal articles on studies on the ketogenic diet and the effect it has on kidney disease and that was in the frontiers of nutrition in august 2021 and were going to talk about it and i want to talk about a little bit of history about the ketogenic diet so its not a new diet even though its new uh to the public its been very popular in the last couple years its been around for over a hundred years to help children control epileptic seizures in conjunction and sometimes when they dont respond to medication but sometimes in conjunction so this diets been out its been studied now in terms of being studied in children in the long-term effects that have the seizures we know that theyre at a higher risk for kidney stones.
Especially if you have kidney disease you should be eating much lower you can take some magnesium citrate or another magnesium product but magnesium citrate is also helpful if your going to try this but overall i dont recommend the keto diet i think theres a lot of other better therapeutic diets out there but as i mentioned this varies with everybody it could help some if you want to try it thats up to you your practitioner but i feel theres other better diets out there for kidney disease make sure to drink plenty of water.
Reason : Better Glycemic Control
Ketone bodies such as BHB or beta-hydroxybutyrate can balance out blood sugar, and lower the bodys answer to glucose, which helps those with type 2 diabetes.
Keeping healthy levels of blood glucose is also good for the reduction of mortality in patients affected by kidney disease.
One study was conducted in which 24000 participants affected by diabetes mellitus took part. Researchers examined these participants and examined the HbA numbers of the participants as an indication of control over glycemics. This is a commonly used indicator of healthy levels of blood glucose.
The study found that those with CKD and diabetes who had lower levels of HbA numbers had higher mortality numbers.
A different study examined nephropathy in mice with diabetes. The mice were placed onto a keto diet and 7 days later levels of blood glucose had normalized. Meanwhile, mice that were in the studys control group, which were given a high carb diet, did not fare as well as several of them died.
2 months after it was discovered that DN had reversed for the rodents following the keto diet.
This suggests that the keto diet is effective in terms of glycemic control plus the prevention of early death as a result of kidney disease.
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Vlckd Is Confirmed As A Safe And Effective Tool For Weight Loss And Metabolic Improvement In Subjects With Obesity
Ninety-two patients with obesity were consecutively evaluated. The mean age was 51.3 ± 12.2 years the mean BMI was 33.8 ± 5.8 kg/m2. Baseline characteristics are summarized in . After the dietary intervention, body weight and BMI were significantly decreased, and BIA data showed this was predominantly caused by a significant reduction in fat mass, with a minor yet significant and expected loss in muscle mass. Of note, 1.1% of patients were deemed as non-responders, with < 5% weight loss achieved 11% reached a weight loss between 5% and 10% the majority of patients lost 10 to 20% initial weight , with 24.2% reaching a weight loss equal to or exceeding 20%. A reduction in Total, Intra and Extra cellular water was also observed, consistent with the known diuretic effect of ketogenic diets . Both systolic and diastolic blood pressure improved over time, and 33.3% of those on antihypertensive medication had it reduced or discontinued due to the blood pressure lowering. Glucose metabolism evaluation showed a frank improvement, with a significant decrease in both fasting glycaemia and HbA1c. Lipid metabolism assessment demonstrated a significant reduction in total cholesterol and triglycerides levels, and no significant modification in HDL and LDL levels. Uric acid and ferritin were also significantly decreased .
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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The Possibility Of Low Blood Sugar Can Make Keto Risky For People With Diabetes
Carbohydrates help control blood sugar levels, which are of particular importance for people with diabetes. A study published in May 2018 in the journal Diabetic Medicine shows that while a keto diet may help control HbA1c levels , the diet may also cause episodes of hypoglycemia, which is a dangerous drop in blood sugar. Echoing many registered dietitians, the Lincoln, Nebraskabased sports dietitian Angie Asche, RD, says she is hesitant to recommend a ketogenic diet for individuals with type 1 diabetes.
The same goes for people with type 2 diabetes. While some preliminary research suggests the keto diet may be safe and effective for certain people with type 2 diabetes, theres still the risk for low blood sugar, especially for those on insulin, and the keto diet omits certain food groups known to benefit those with this disease. For example, a study published in September 2016 in the journal Nutrients highlights the importance of whole grains for helping to control weight as well as episodes of high blood sugar. Whole grains are off-limits on the ketogenic diet.
The best course of action is to proceed with caution and consult a professional before diving in. If you have a medical condition or are on medications, you should always consult with your doctor before beginning a ketogenic diet, Asche says.
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Do Low Carb Diets Damage The Kidneys Probably Not
Low carb diets, such as Atkins, which are popular for people who want to lose weight, have been found not to cause any noticeable harm to the kidneys, researchers from Indiana University School of Medicine reported in the Clinical Journal of the American Society of Nephrology. The authors added that although their study detected no harmful effects on the kidneys, they say further follow-up studies are required to confirm this.
Allon Friedman, M.D. and team set out to determine what effects a high-protein low-carb versus a low-fat diet might have on the kidneys. They compared the two diets on a wide range of kidney-related measures.
The study involved 307 participants over a two year period. None of them had any kidney problems or diseases before the study began.
They found that a high-protein low-carb diet did not appear to have any harmful effects on kidney functions, neither were fluid and electrolyte balances affected.
Dr. Friedman said: These results are relevant to the millions of healthy obese adults who use dieting as a weight loss strategy.
In order to determine whether there might be any longer-term effects than the two years in this study, the authors said that further long-term studies are required. Further studies are also needed on patients with certain diseases and conditions, such as those at high risk of developing kidney stones, high blood pressure , diabetes, and chronic kidney disease.
In an Abstract in the same journal, the authors wrote:
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May Damage Bone Health
The keto diet is also associated with impaired bone health.
Several studies in animals link the keto diet to decreased bone strength, likely due to losses in bone mineral density, which may occur as your body adapts to ketosis .
In fact, a 6-month study in 29 children with epilepsy on the keto diet discovered that 68% had a lower bone mineral density score after going on the diet .
Another study in 30 elite walkers determined that those who followed keto for 3.5 weeks had significantly higher levels of blood markers for bone breakdown, compared with those who ate a diet higher in carbs .
All the same, more extensive research is warranted.
summary
The keto diet may reduce your bone mineral density and trigger bone breakdown over time, though further studies are needed.
About Sudip Ghimire Md
Sudip Ghimire, MD, is a fellowship trained nephrologist in Newport News, VA with nearly 20 years of experience in the field. He joined TPMG Nephrology in Newport News in 2020. Dr. Ghimire provides kidney disease care for adults from 18 years of age and older. He treats a broad range of conditions related to the kidneys such as acute kidney injury, chronic kidney disease, hypertension, glomerulonephritis, electrolyte disorder, metabolic management of kidney stones, peritoneal dialysis, hemodialysis, and dialysis-related care. His medical interests include electrolyte disorder, bone mineral disease, and hypertension.
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The Keto Diet For Kidney Disease: What Ckd Patients Should Know
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Even after many years of varying diet trends, the keto diet is still around. Is there a place for the keto diet for kidney disease?
With stage 3, stage 4, transplant or any other stage of kidney disease, there are important factors to consider when it comes to a diet- ketogenic or not.
Lets dive into what the keto diet for ckd patients is all about!
Does The Keto Diet Have Any Kidney Benefits
Despite these potential problems, there are actually some powerful kidney benefits that come along with the keto diet. Specifically within those who struggle with diabetes, the keto diet has been linked to reversing the effects of diabetic neuropathy, which is a result of impaired kidney function from diabetes.
It has this effect on diabetic neuropathy primarily via increasing our bodys ability to control glycemic levels, and by altering the actual genetic expression within the kidneys.
For glycemic levels, one study found that diabetic mice who were placed onto the ketogenic diet saw results of more controlled glycemic levels, with normalized blood glucose levels.
In a recent study, researchers found that the genes that are responsible for neuropathy within diabetic patients were reversed within mice that were placed on a ketogenic diet and were confirmed in states of ketosis.
Lastly, the ketogenic diet has also proven to be beneficial for those who already struggle with kidney disease, particularly when it comes to cardiovascular health.
Those that have chronic kidney disease , have a directly increased risk in developing cardiovascular disease , and that those with CVD have an increased risk of developing CKD conversely.
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