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:
The Real Culprits Behind Chronic Kidney Disease
The two main causes of chronic kidney disease are diabetes and high blood pressure. As you just learned, a ketogenic diet can improve both of these risk factors.
Other risk factors include:
- Family history of kidney disease
- Cardiovascular disease
- Chronically high blood sugar levels
Weight control is also crucial for maintaining healthy kidney function. Obese people are more prone to chronic kidney disease, and obesity can be largely attributed to processed, high carb diets.
Following a ketogenic diet can significantly help with weight loss, blood sugar control and improve kidney function which can help prevent kidney damage.
Serious Muscle Loss Is A Possible Side Effect Of Keto
Muscle loss on the ketogenic diet is an ongoing area of research, says Edwina Clark, RD, a dietitian in private practice in San Francisco. Small studies suggest that people on the ketogenic diet lose muscle even when they continue resistance training. This may be related to the fact that protein alone is less effective for muscle building than protein and carbohydrates together after exercise. Meanwhile, according to a small study published in March 2018 in the journal Sports, people following the keto diet for three months lost about the same amount of body fat and had about the same muscle mass changes as people following normal diets. Yet the folks on keto did lose more leg muscle.
Loss of muscle mass as we age has a number of serious consequences, notes Clark. Muscle is metabolically active and helps boost daily energy expenditure and mitigate age-related weight gain. Losing muscle mass can also decrease functional strength and heighten the risk of falls, notes Clark. Falls are the top cause of death from injury in older populations, according to the Institute of Medicine Division of Health Promotion and Disease Prevention.
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What Everyone Should Do Before They Attempt The Keto Diet
The bottom line? If youre thinking about trying the ketogenic diet, run it by your doctor first regardless of any preexisting health conditions. And consult a registered dietitian nutritionist to find a nutrition professional who can work with you to create a meal plan you can stick to. People with kidney disease or a history of disordered eating should avoid the diet, and people with type 1 diabetes may want to avoid it, as well. If you have risk factors for heart disease, youll want to speak with your doctor before considering the diet.
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.
Loading up on red meat,processed meat, and saturated fat and restricting carbohydrate-rich vegetables, fruits, legumes, and whole grains is a recipe for bad health, he explained.
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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Positive Results With Keto Diet For Autosomal Dominant Polycystic Kidney Disease
Department of Molecular, Cellular, and Developmental Biology and Neuroscience, Research Institute,University of California Santa Barbara,Department II of Internal Medicine and Center for Molecular Medicine,Faculty of Medicine and University Hospital Cologne,University of Cologne,Germany
Ketogenic diet interventions which instead of drawing fuel from glucose obtained from carbohydrates, drive the body to use ketone bodies produced by the liver from stored fatlimit protein intake, and some studies have shown some possible health risks associated with prolonged adherence. But there are also benefits associated with this diet plan, including weight loss.
Lab work in animal models by Sebatian Stubl, MD, and colleagues has suggested that KDIs or time-restricted diets may lessen autosomal dominant polycystic kidney disease progression. The lining cells of the cysts in polycystic kidney disease rely on glucose as an energy source, and mouse models have shown that a restriction of this energy source can decrease renal cyst growth. Our findings indicated that PKD cysts cannot adapt to the metabolic changes in ketosis, which could potentially be exploited therapeutically, wrote Dr. Stubl and colleagues in Clinical Kidney Journal.
Keto Diet And Creatinine Levels
Creatinine, a waste product that naturally occurs in the body, can build up over time with chronic kidney disease. So would a keto diet help creatinine levels?
There is noresearch at this time that focuses on the keto diet and creatinine levels in those with chronic kidney disease.
One study did measure the effect of creatinine clearance between a low-carb/high-protein vs. low-fat diet. The study, however, used obese adults without any serious medical conditions including kidney disease.
The result in that particular study found that healthy obese individuals had no harmful effects on GFR. But the study also wrapped up with the infamous line, Further follow-up is needed to determine even longer-term effects on kidney function.
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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.
Is The Keto Diet Bad For Your Kidneys
The ketogenic diet is a low-carb, high-fat diet commonly used for weight loss and as a therapy for epilepsy in children. While there are legions of keto diet fans who rave about the benefits, there still is a darker side to this very restrictive diet regime. Namely, the increasing prevalence of kidney stones.
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Plan Out Meals And Snacks
One of the biggest challenges in sticking with a ketogenic diet absolutely requires a plan. Therefore, meal planning, grocery shopping, and cooking are essential in sticking to a keto diet .
Be sure to have healthy snacks planned out and easily available. This can be incredibly helpful when it comes to preparation and satisfying hunger when you dont have the time or energy to make a meal.
Dietary Changes That Correct Metabolic Acidosis Can Suppress Complications Of Ckd
The genesis and treatment of metabolic acidosis has long been a favorite teaching exercise for nephrologists . This interest arises in large part because this complication of CKD causes substantial loss of muscle mass . The scope of topics regarding the treatment of metabolic acidosis has grown substantially because it has been reported that correction of metabolic acidosis by dietary manipulation can effectively suppress the accelerated loss of kidney function in patients with progressive CKD. This insight was first detected when it was found that the serum levels of bicarbonate were inversely associated with increases in serum creatinine in the calculation of estimated GFR . For example, Shah et al., examined clinical chemistry results obtained from adults attending a University Medical Clinic over a 2 year time period . In their study of 5422 patients with various kidney diseases, including diabetic nephropathy, 337 patients were found to have evidence of CKD progression as assessed by declining eGFR. In patients with serum bicarbonate concentrations 22 mEq/L, the hazard ratio for the progression of kidney disease was 1.54 after adjustment for potential confounders compared to the reference group . Similar results were obtained using different definitions of the renal outcome .
Fig. 1
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Is Keto Diet Safe For Kidney Disease
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May Cause Dangerously Low Blood Sugar
Low carb diets like keto have been shown to help manage blood sugar levels in people with diabetes.
In particular, some studies suggest that keto may help decrease levels of hemoglobin A1c, a measure of average blood sugar levels .
However, individuals with type 1 diabetes may be at a high risk of more episodes of low blood sugar , which is marked by confusion, shakiness, fatigue, and sweating. Hypoglycemia can lead to coma and death if not treated.
A study in 11 adults with type 1 diabetes who followed a ketogenic diet for over 2 years found that the median number of low blood sugar events was close to 1 per day .
Individuals with type 1 diabetes typically experience low blood sugar if they are taking too much insulin and not consuming enough carbs. Thus, a low carb keto diet may increase the risk.
Theoretically, this could also happen to individuals with type 2 diabetes who are taking insulin medications.
Summary
Even though low carb diets have been shown to improve blood sugar control in people with diabetes, they may also increase your risk of low blood sugar events especially if you have type 1 diabetes.
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What Is A Low Protein Diet
A low protein diet aims to restrict protein intake to between 20 40 gms of protein per day depending upon the size, age and gender of the client. Generally, younger males who are still fairly active require a slightly higher protein intake to preserve muscle mass.
20 gms of protein is the equivalent of a chicken breast, which would be the TOTAL amount of protein allowed to be consumed in a day.
Calories are bumped up by using high-quality good fats coupled with plenty of alkaline vegetables. The addition of highly alkaline foods coupled with a low protein diet further helps support healthy kidney function and reduces an unnecessary toxic load upon the kidneys by reducing the uremic load and TMAO production.
The diet is followed for 3 4 months and then the eGFR is rechecked to make sure that the eGFR is stable or even improved.
Is Ketogenic Diet For Warfarin A Double
Along with the impressive specific effects that keto can have, offer come to some drawbacks for people with an interest in trying it.
While there are some studies that support the potential benefits of the ketogenic diet for patients with high blood pressure, cancer, type 2 diabetes, Alzheimers, and epilepsy, it hasnt been supported as high for people with kidney failure.
Ive heard a few specific cases where people with kidney failure failed to produce ketones in their body, even though reaching said the state is recommended when trying to start the ketogenic diet.
But overall, its still a diet that can be reasonably done on a long-term basis. The complication faced by people on warfarin with kidney failure is related to vitamin K depletion.
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How Kidneys Are Damaged
Many different diseases, drugs, toxins, and inherited disorders can lead to kidney damage.
However, by far the two most common causes of kidney disease are diabetes and high blood pressure, both of which can damage the kidneys delicate blood vessels and tissues.1
When the root causes of these two diseases are not addressed, chronic kidney disease and ultimately kidney failure can be the result. In the US, diabetes causes 44%, and high blood pressure causes 29% of all cases of end-stage kidney failure requiring dialysis or a kidney transplant.2
Why does this happen?
In the case of diabetes, high blood sugars over long periods of time can cause glucose to bind to vital proteins in the bloodstream. This process, known as glycation, results in the formation of advanced glycation end-products . AGEs can cause abnormal changes to proteins and to receptors that ultimately injure the filtering segments of the kidney. This glycation creates a vicious cycle of additional injuries to tissues that results in progressive kidney damage, called diabetic nephropathy.3
With high blood pressure, the problem is simply too much pressure. Exposing the delicate filtering portion of kidneys to blood that is moving too hard and fast causes scarring, which damages the kidneys. This results in a loss of kidney function, leading to chronic kidney disease or eventually kidney failure.4
Takeaway:
New Strategies To Improve Lean Body Mass A Complication Of Ckd
In patients with CKD, muscle wasting and limited physical performance can substantially contribute to reduced confidence and the risk of injuries. This is especially true for patients who are bedridden or immobile . For example, measurements of the physical status of 385 patients with stages 24 CKD, uncovered a reduction in muscle mass plus variabilities in the functional abilities of different muscles . The authors concluded that patients with CKD were characterized by leg performances that were at least 30 % lower than predicted while handgrip strength was relatively preserved. The major abnormality in muscle functioning was a reduction in measurements of walking speed and the timed and up and go testing. The presence of these abnormalities predicted a 3-year risk of death, was more reliably than variations in the degree of CKD or the presence of other biomarkers, and when eGFR levels were combined with measurements of walking, the mortality predictions were more accurate. In summary, impaired physical performance of the lower extremities is common in CKD and strongly associates with all-cause mortality.
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Low Carbohydrate Diet May Reverse Kidney Failure In People With Diabetes
- Date:
- The Mount Sinai Hospital / Mount Sinai School of Medicine
- Summary:
- Researchers have for the first time determined that the ketogenic diet, a specialized high-fat, low carbohydrate diet, may reverse impaired kidney function in people with Type 1 and Type 2 diabetes.
Researchers from Mount Sinai School of Medicine have for the first time determined that the ketogenic diet, a specialized high-fat, low carbohydrate diet, may reverse impaired kidney function in people with Type 1 and Type 2 diabetes. They also identified a previously unreported panel of genes associated with diabetes-related kidney failure, whose expression was reversed by the diet.
The findings were published in the current issue of PLoS ONE.
Charles Mobbs, PhD, Professor of Neuroscience and Geriatrics and Palliative Care Medicine at Mount Sinai School of Medicine, and his research team evaluated mice that were genetically predisposed to have Type 1 or 2 diabetes. The mice were allowed to develop diabetic nephropathy, or kidney failure. Half of the mice were put on the ketogenic diet, while the control group maintained a standard high carbohydrate diet. The researcher founds that after eight weeks, kidney failure was reversed in the mice on the ketogenic diet.
This study was funded partly by the National Institutes of Health and by the Juvenile Diabetes Research Foundation.
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