Endocrine

The case for a ketogenic diet in the management of kidney disease

Chronic kidney disease, including diabetic kidney disease, poses significant health challenges and contributes to high morbidity and mortality rates. Traditional dietary recommendations for kidney disease include protein restriction.

Although often mistakenly described as being high in protein, a ketogenic diet is moderate in protein, high in fat, and very low in carbohydrates.

Recently, researchers reviewed findings from clinical trials, observational studies, and animal research to provide an overview of the ketogenic diet’s effects on kidney disease.

A few of their key findings and analyses:

1. Renal function: Emerging research suggests that ketogenic diets may slow or even reverse the decline in kidney function in patients with moderate kidney disease (stage 2 or 3 chronic kidney disease).
2. Inflammation and oxidative stress: Nutritional ketosis is associated with reduced levels of C-reactive protein and other inflammatory markers. Beta-hydroxybutyrate has been shown to suppress inflammation and reduce oxidative stress, potentially providing renal protection.
3. Misconceptions: Common concerns about ketogenic diets, such as excessive protein intake and increased acid load, are not necessarily applicable to well-formulated ketogenic diets, which can also be designed to avoid renal stressors like purines and oxalates.
4. Safety: A ketogenic diet appears to be safe for individuals with moderately reduced kidney function and, with proper monitoring, can be effectively prescribed to patients with type 2 diabetes who have stage 2 or 3 chronic kidney disease.

The authors conclude that a ketogenic diet holds promise as a therapeutic strategy for managing kidney disease. However, they emphasize the need for further studies, individualized treatment plans, and close monitoring to mitigate any risks.