Keto Diet And Stage 3 Kidney Disease

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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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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.


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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Control Your Portion Sizes

Eating too much of anything, even healthy foods, can be a problem. The other part of a healthy eating plan is portion control, or watching how much you eat.

Good portion control is important in a kidney-friendly eating plan, because you may need to limit how much of certain things you eat and drink.

To help control your portion sizes:

  • For packaged foods, check the nutrition facts label to learn the serving size and how much of each nutrient is in one serving. Many packages have more than one serving. For example, a 20-ounce bottle of soda is really two-and-a-half servings.
  • For fresh foods that do not have nutrition facts labels, such as fruits and vegetables, ask your dietitian for a list of nutrition facts to measure the right portions.
  • Eat slowly and stop eating when you are full. It takes about 20 minutes for your stomach to tell your brain that you are full. If you eat too quickly, you may eat more than you need.
  • Avoid eating while doing something else, such as watching TV or driving. When you are distracted, you may not realize how much you have eaten.

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Foods Allowed On The Keto Diet

The ketogenic diet is one of the more restrictive diets as it eliminates a carbohydrates, the main source of energy.

Examples of foods that are commonly found in a keto diet include

  • Low-carb veggies

Most people who say they follow a ketogenic diet are likely not in true ketosis. That requires at least 2 days but up to weeks of following a strict diet just to use up the glucose stores and enter the process of ketogenesis.

In other words, there can be no such thing as a cheat day on a keto diet. In those cases, the diet is likely more of a low-carb, moderate to high-protein and/or high fat diet.

How Is A Kidney Disease Diet Different

The Keto Diet and Kidney Function | A Kidney Doctor Explains | The Cooking Doc®

People following a kidney disease diet might need to change the amount of fluids and/or the following nutrients in their diet:

Eating the right amount of these nutrients may help control the buildup of fluid and waste in your body. This helps your kidneys to not work as hard to filter out the extra waste and fluids from your blood.

You will most likely still be able to include small amounts of foods with these nutrients. If your kidney function worsens, however, you might need to be more strict or make additional dietary changes. Based on your blood test results, your healthcare team will let you know if you need to change anything in your diet.

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Diet And Nutrition Goals For People With Stage 3 Chronic Kidney Disease

In stage 3 chronic kidney disease , the kidneys still function sufficiently to remove fluid, potassium potassium and a moderate amount of waste. In order to help slow the progression of CKD, managing blood pressure, glucose and weight, among other things, is important and can be done through adhering to a kidney diet.

To get started, check out these eight diet and nutrition goals when you have stage 3 CKD:

1. Count your calories.

Adequate calories can either prevent weight loss if youre at a desirable weight or provide extra calories if you are underweight. Weigh yourself often and keep track to see if you need additional or fewer calories. Your dietitian will determine a desirable weight and monitor your progress.

2. Eat the right kinds of fats.

If you have cardiovascular disease or your blood cholesterol is high, unhealthy fatssuch as saturated fats and trans-fatsshould be replaced by poly- and monounsaturated fats from vegetable oil, canola oil and olive oil. A limit on high cholesterol foods is recommended.

3. Watch for symptoms of fluid retention.

Fluid is not restricted in stage 3 CKD unless you experience fluid retention. Sudden weight gain, shortness of breath, swelling in the feet, hands and face and high blood pressure are signs of fluid retention. These symptoms may indicate a decline in kidney function and decreased urine output.

4. Reduce your phosphorus intake.

5. Monitor your potassium levels.

6. Know your recommended daily intake of protein.

Final Thoughts Keto Diet And Stage 3 Kidney Disease

When dieting, it is best to limit carbohydrates to 20g per day, and ideally, you should aim to keep this amount below 30 grams. However, if you are looking to lose weight, it is better to eat less carbs every day. When you do eat carbs, you should consume them as protein, with fat filling up the remainder. Depending on the type of food you ate, you may have to cut back on the amount of total carbs you consume, but the results will be worth it.

To maximize the benefits of the keto diet, you should eat more fat-rich foods. These are generally higher in saturated fat than those found in other food groups, and therefore contain more sugar than is recommended. High-fat food sources are often associated with contaminants and hormones, so it is advisable to buy products from organic sources. You should also try to eat as much produce as possible that is local and organic. The Environmental Working Group provides a list of the least-contaminated foods and the ones that should be avoided.

While many people might think that avoiding processed meats is difficult, this isnt true. Some are high in carbohydrates but low in vitamins and minerals. You should also avoid breads made from flour, which are often highly processed. Moreover, try to eat more seafood and shellfish instead, as they contain significant amounts of carbohydrates. To keep your body healthy, it is important to maintain a proper mindset, which is essential to follow the ketogenic diet.

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Stage 3 Kidney Disease Diet

Living with reduced kidney function demands serious attention to your diet. The most important thing is to exclude certain foods from your diet that include phosphorus and potassium.

1. Consume Proper Amount of Calories

Calories provide your body with energy. When determining how much calories to take, you need to consider how underweight or overweight you are. Other factors like gender, age and your activity level will also have impact on the amount of calories you need.

Eating fewer calories may be important when you have stage 3 kidney disease, but it will make you lose weight. Cutting calories will actually help when you are overweight or obese. Therefore it’s important to work with your doctor to know how many calories you need and make a diet plan for it.

2. Limit Phosphorus Intake

Whatever you do, be sure to limit the intake of phosphorus because your kidneys cannot process it. Ensure your diet does not have more than 800mg of phosphorus. You may want to avoid or limit intake of milk, nuts, ice cream, cheese, chocolate, and seeds.

3. Avoid High-Potassium Food

Your stage 3 kidney disease diet should not include food rich in potassium. While potassium is not completely restricted in stage 3 CKD, it still helps to lower your intake of potassium-rich foods to keep it from going up. Some high-potassium foods include bananas, avocados, potatoes, nuts, tomatoes, honeydew, and legumes. You may have to work with your dietician to determine how much potassium you can consume.

How Can A Keto Diet Help You To Avoid Stage 3 Kidney Disease

A Chronic Renal Failure Diet Is Easy With A Meal Plan

As we just mentioned about diabetes and high blood pressure being the biggest culprits for kidney damage, a keto diet can help you big time in the same respect.

In recent years, numerous studies and researches have been conducted to ascertain the role of the Keto diet in avoiding diabetes and high blood pressure.

The diet contains lower amounts of carbs, a macronutrient that has been deemed as one of the biggest reasons for diabetes.

Now, you have to understand that a keto diet can only help you in the earlier stages of the kidney-related issues and not with stage 3 kidney disease to be more specific.

During the later stages of stage 3 kidney disease, the remaining functional portions of the kidney are heavily stressed due to the overload.

So, until and unless the cause for the damage gets treated or reversed, the keto diet cannot bring much difference to the overall situation.

Now, even when you are helping yourself with a keto diet for the early stages of a kidney issue, there are certain precautions that you need to take in the process.

A keto diet consists of moderate amounts of proteins, and if not tracked well, the same intake may lead to the production of kidney stones in the body.

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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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