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, it’s difficult to know what’s healthy and backed by science. The ketogenic (keto) 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 body’s primary source of energy comes from burning fat rather than carbohydrates. Meaning, you aren’t 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.

High Dietary acid load generated by the consumption of high animal fat and protein is associated with albuminuria (losing protein in urine) and the onset of chronic kidney disease. In addition to increasing your chances of developing chronic kidney disease, research has linked the keto diet to an increased decline in kidney function for those who already have chronic kidney disease. When you eat a high protein diet, the kidney must work harder because of increased blood flow to the filtrating unit of the kidney called Hyperfiltration, which leads to the progression of chronic kidney disease. A Keto diet potentially worsens metabolic acidosis, which is a common complication of chronic kidney disease, which ultimately affects bone and muscle health as well.

Those with or at risk for kidney disease can still find healthy alternative diets that can help with weight loss. 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. Additionally, restricting or reducing salt intake, particularly if you have high blood pressure, and ensuring proper hydration will alleviate stress on the kidneys. Those with advanced kidney disease might also want to pay extra attention to foods rich in potassium and phosphorus as your kidney may not be able to handle the load which causes complications.

“Consult with your physician or a nephrologist and go over lifestyle changes and dietary modification,” said board certified nephrologist, Sudip Ghimire, MD, FASN of TPMG Nephrology. Your dietary restrictions are different depending on your renal health. Those with healthy kidneys might not need the same nutrients as those with an advanced case of kidney disease.

Your weight loss journey shouldn’t negatively affect your health. Talk with a TPMG nephrologist today, and discuss foods that are beneficial for kidney health like the renal diet.

Dr. Ghimire

About Sudip Ghimire, MD, FASN

Sudip Ghimire, MD, FASN 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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