Can Keto Cause Kidney Stones

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The Keto Diet: Helping You Lose Weight Or Hurting Your Kidneys

Ketosis and Kidney Stone Prevention Dr. Berg

Weight loss can be a difficult journey. With all the diets, nutrition plans, and weight loss programs out there, its difficult to know whats healthy and backed by science. The ketogenic 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 bodys primary source of energy comes from burning fat rather than carbohydrates. Meaning, you arent 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.

What You Need To Know About A Low

First, well look at what our kidneys do and how they can get damaged.

Then, we will examine the research on low-carb diets for the average low-carb eater with healthy kidneys. We will evaluate the two biggest concerns most potential low-carbers have:

  • Will a high-protein, low-carb diet stress kidney function?
  • Do low-carb diets lead to kidney stones?
  • Our last section will evaluate the evidence about the safety of low-carb diets for those with a confirmed diagnosis of either mild or advanced kidney disease.

    Feel free to use the linked outline above to skip to the section most relevant to your health history.

    Keto Can Put Stress On The Kidneys And Possibly Give You Kidney Stones

    Kidney stones are a well-noted potential side effect of the ketogenic diet. ResearchJournal of Child Neurology observed that among children following the keto diet as a treatment for epilepsy, 13 out of 195 subjects developed kidney stones. Children supplementing with potassium citrate in the study noticed a decreased likelihood of kidney stones. Speak with your healthcare practitioner about supplementing if kidney stones are a concern.

    If youre going to do keto, theres a better and a worse way to do it, says Yawitz. Loading your plate with meats, and especially processed meats, may increase your risk for kidney stones and gout, which is a painful type of arthritis. High intake of animal proteins makes your urine more acidic and increases calcium and uric acid levels. This combination makes you more susceptible to kidney stones, while high uric acid can increase your risk for gout, adds Yawitz.

    And the ketogenic diet can be dangerous for people with kidney disease, as people with kidney disease need to follow an individualized diet as prescribed by their doctor. According to Davita Kidney Care, people with kidney disease often need to consume a low-protein diet, which may not align with the type of keto youre following.

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    But My Friend Followed An Isolate Diet With Keto And Had Kidney Stones

    An increased level of uric acid in the blood is one of the significant consequences of the Metabolic Syndrome. And, during the ketosis state, excessive ketones are excreted mainly via the urine. However, our body also removes them via feces and the breath .

    With that said, it is possible for someone on a keto diet despite containing low amounts of purines to develop kidney stones.

    Clearly, there must be another contributory factor other than a diet rich in purines.

    Such a scenario is especially noticeable in the early weeks of a ketogenic diet protocol which may contribute to gout or kidney stone. At this stage, the body cells dont have all the enzymes needed to use ketones as a source of energy altogether. As a result, some of the unutilized ketones are removed from the body.

    Ketones are a little bit acidic and therefore tend to increase the acidity of urine. Leaving this condition unaddressed may lead to a gout attack at the early stage of ketosis, and uric acid stones may form in the kidney.

    Now you know the reason why many people attribute a risk factor associated with the keto diet and kidney stones.

    Is Keto Bad For Your Liver And Kidneys

    Does Keto Cause Kidney Stones

    We have been reading that a keto diet that is well formulated helps your kidneys instead of hurts them.

    As long as you are eating clean and hitting your macros you should have nothing to worry about and actually should be alarmed to all of the benefits that comes with achieving ketosis.

    Benefits such as increased energy, more focus, no more brain fog, better mood, and weight loss to mention just a few.

    Regardless of what I say, you should always check with your doctor first, especially if you already have issues with your kidneys or liver.

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    Keto Could Cause Your Blood Sodium To Dip

    When you start the keto diet, you lose sodium and other electrolytes in the urine due to reductions in insulin, says Yawitz. This is a major contributor to symptoms of keto flu. So its important to replenish sodium through the diet, especially if you exercise or sweat a lot. This can help ward off more serious side effects that are seen with long-term sodium deficiencies, says Yawitz. These include lethargy and confusion and in extreme cases, seizures, coma, and death, according to the Mayo Clinic.

    Is There Any Evidence That Proves The Increasing Risk Of Kidney Stones Due To Keto

    We can understand your curiosity and hence, we have gathered all the information about the bits and pieces of evidence regarding keto and kidney stones. Dont worry, we have covered you well. At the end of this article, you will get the answers to all your questions.

    According to a study, kidney stones are found in children with epilepsy. They have used extreme versions of keto diets. However, potassium citrate supplements can reduce the risk of kidney stones to an extent.

    Apart from this study, there has been NO evidence that shows that kidney stones are caused by keto or other low-carb diets.

    But as we all know, the internet is full of anecdotal evidence. Every person comes up with his own theory which has no base, to be honest. Isnt it? Cmon, who are we lying!!

    This case is no different, many individuals have reported that theyve developed kidney stones after following ketogenic diets.

    But know that, kidney stones are very common in America. About 10% of male and 7% of females suffer from this problem due to the standard American diet. It has nothing to do with keto or other low carb diets. You can sigh in relief now!

    Apart from these self-proclaimed experts, there are a few other factors that can be the root cause of kidney stones in individuals. The biggest potential risk is to those individuals who are already suffering from kidney issues, going on keto may result in stones. Another reason is the hereditary cause.

    Below is the detailed note on these mistakes.

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    How Long Does A Kidney Stone Take To Form

    You can have kidney stones for years without realizing it. You will not feel anything as long as these stones remain in your kidney. A kidney stones pain usually begins as it moves out of your kidney. A stone can sometimes form in a few months.

    Discuss your risk factors with your healthcare physician. A 24-hour urine test may be performed to determine how quickly you produce stones.

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    What Makes Ideal Protein A Better Option Over A Traditional Keto Diet

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

    Many weight-loss programs similar to the Ideal Protein diet try to completely prevent ketosis by providing a low-calorie diet with a moderate amount of protein. However, they include enough carbs in the diet to avoid ketosis in order to prevent kidney stones and gout.

    This type of Ideal Protein alternative would be okay for the do-it-yourself diets or at-home patients requiring little monitoring to reach their desired weight.

    Yes, the patients will drop weight on these programs. But, they will not get the full benefits they would have enjoyed on a pure ketogenic protocol.

    First of all, it will take them longer to achieve their weight-loss goal since an exact ketogenic diet is the best means to burn fat quickly.

    Plus, by cutting down the amount of carbs in their diet, the patient has a slim chance of restoring the pancreas and giving the cells ample time to regain their insulin sensitivity.

    Only a medical-grade weight loss protocol, like the Ideal Protein protocol, can provide all these health benefits. Also, patients dealing with signs of Metabolic Syndrome shouldnt settle for less.

    It is noteworthy that the Ideal Protein ketogenic protocol may be beneficial for gout patients as it greatly helps in weight loss.

    In our experience, kidney stones occur rarely in a well-formulated keto diet.

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    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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    Ketosis Effects On The Kidneys

    Very high levels of ketones make your blood more acidic and overburden your kidneys. “Medical News Today” reports that one of the side effects of a ketogenic diet is the formation of kidney stones. In processing higher amounts of protein, your kidneys work hard and are forced to excrete more sodium, calcium and potassium, as well as filter more of the byproducts of protein metabolism. This extra fluid and electrolyte loss can cause low blood pressure, another function mediated by your kidneys. Ketosis in the presence of diabetes can lead to ketoacidosis and coma, and can be life threatening.

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    What Are Kidney Stones

    Kidney stones are made up of minerals and salts that have not been properly eliminated from your body. They typically start small but can grow larger in size, even filling the hollow structures of your kidneys.

    Its possible for these stones to stay in place and not cause any issues at all. However, if they travel down the tube between your kidney and bladder , they can either be eliminated in your urine, or it can become lodged in your ureter.

    If the latter happens, the kidneys stones may end up blocking the flow of urine from the kidney and causing pain. Passing a kidney stone can be quite painful, but it typically doesnt cause permanent damage.

    Common symptoms associated with kidney stones include :

    • Pain in the side and back, and below your ribs
    • Pain while urinating
    • Urinating more often or less often than usual
    • Fever and chills

    May Lead To Nutrient Deficiencies

    Gout, Kidney Stones, &  the Ketogenic Diet

    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.

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    Is There Really A Diet For Kidney Stones

    Kidney stones are more common than you might think. Its hard to pinpoint the exact reason, but one in ten people will develop a kidney stone at some point. Some factors may be genetics, not drinking enough water, obesity, high sugar and salt intake, kidney disease, weight loss surgery, and mega-dosing on dietary supplements.

    As you may have guessed, diet is often at the root of kidney stones. While there isnt a single type of diet that causes kidney stones or can cure it, many of todays popular low-carb, high-protein diets can change the composition of urine, making kidney stone formation more likely. Not drinking enough water and consuming large amounts of fructose, like table sugar and high fructose corn syrup, are also linked to kidney stones.

    If youve had kidney stones, figuring out the best diet to relieve or prevent more stones depends on what kind of stone you have. The most common ones are calcium oxalate, calcium phosphate, uric acid and struvite stones.

    Calcium phosphate stones occur less often, about 10% of the time. A high-sodium and high-animal-protein diet increases your chance of getting phosphate stones. If you have this type of stone, replacing animal proteins with more plant-based proteins, like beans, peas, and lentils, soy foods, nuts, and seeds, can be beneficial. Again, you dont need to be on a low-calcium diet. A dietitian can help you with limiting salt and getting the right amount of calcium.


    Myth : Keto Diet Causes Kidney Stones

    Kidney stones form when mineral deposits crystalize together in the kidneys. The crystals primarily consist of insoluble calcium other constituents include oxalates and uric acid. Since ketogenic diets cause an increased loss of electrolytes, some people speculate this can lead to kidney stone formation.

    Yet, there isnt any evidence to back this up claim.

    In fact, most research shows low-carb diets generally improve kidney function. Which is especially true for those keto dieters who stay hydrated and make sure to keep their electrolyte levels up. On the Keto Zone diet we recommend that you drink enough water to stay hydrated. We also recommend that you supplement with electrolytes from Instant Ketones.

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    Is A Keto Diet Healthy

    Except for some rare medical conditions, I do not recommend a keto diet for the vast majority of people. A keto diet is not sustainable lifelong. It also restricts many healthy food groups such as whole grains, fruit, dairy, and some vegetables.

    In addition, due to excess fat, a keto diet could also increase risk for heart disease, stroke and fatty liver.

    High fat diets also appear to have negative impacts on gut bacteria. The community of bacteria that live in our intestines do more for us than we will probably ever know. Changes to the gut bacteria are linked to high blood pressure, inflammation, altered nutrient metabolism, and even kidney disease.

    Your Period On Keto Might Undergo Some Changes

    Uric Acid Kidney Stones & Keto Diet Dr. Berg

    Periods may become irregular or completely stop on the keto diet, says Yawitz. This is more due to rapid weight loss than the diet itself and happens because of drops in gonadotropin-releasing hormone, follicle-stimulating hormone, luteinizing hormone, estrogen, and progesterone.

    Long-term disruption of menstruation can bring on serious side effects, including low bone density. This is because estrogen is very important to bone health, says Yawitz. Studies have also found prolonged menstrual irregularity to increase risk for cardiovascular disease, depression, anxiety, and sexual dysfunction. Its important to contact your ob-gyn if your cycles become irregular or if you stop having periods.

    But wait, theres one loophole. Have polycystic ovary syndrome ? Then the keto diet may help regulate your periods. Women with PCOS have high insulin levels, which cause sex hormone imbalances, notes Yawitz. In a small study published in the journal Nutrition & Metabolism, subjects with PCOS following a ketogenic diet for six months noted improvements in their menstrual cycles and a small number of women became pregnant, overcoming previous infertility obstacles. This study was very small, so we cant make recommendations for all women with PCOS based on its findings, says Yawitz. And really, any diet that leads to weight loss should help in PCOS.

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    Excessive Protein On Keto Diets

    Although a true keto diet isnt high in protein, diet culture keto tends to be incredibly high in protein. There isnt a formal definition for diet culture keto, but I would guess many people are easily eating 4x their protein needs.

    All this extra protein causes a dramatic drop in urine pH. During metabolism, dietary protein produces acid. Assuming someone has normal kidney function, the body gets rid of extra acid via the urine. High urine acid levels make both uric acid and calcium oxalate kidney stones more likely.

    Excess protein can also increase urine calcium, which is another risk factor for kidney stones.

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