Exploring the Benefits and Risks of the Keto Diet for People with Kidney Disease

The ketogenic diet, or "keto" diet, is a high-fat, low-carbohydrate diet that has become increasingly popular in recent years, particularly for those with obesity and metabolic syndrome. However, some experts have raised concerns about the safety of the keto diet, particularly for people with chronic kidney disease (CKD) and those at risk of developing kidney stones or renal failure.

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The kidneys are responsible for filtering waste products and excess fluids from the blood, regulating blood pressure and maintaining electrolyte balance. The high fat and low carb nature of the keto diet can put a strain on the kidneys, leading to an increase in acidity in the blood and dehydration, which can further decrease renal function. This can lead to a build-up of waste products in the blood, such as creatinine, and cause a variety of health problems.

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Additionally, people with CKD are often advised to limit their intake of protein, as high protein intake can place an additional strain on the kidneys. However, the standard keto diet is typically high in protein, which could be problematic for those with kidney disease. Furthermore, high fat intake associated with keto diet can also lead to changes in lipid metabolism and increase the risk of hyperuricemia (high uric acid levels leading to gout).

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It's important to note that the conventional keto diet may not be suitable for everyone and it is not recommended for individuals with CKD or at risk of developing kidney stones or renal failure. If you have a history of kidney disease or are at risk of developing it, it is important to consult with a healthcare professional before starting a keto diet. They will be able to advise you on the best course of action based on your individual health needs, including monitoring glucose and creatinine levels, electrolytes and hydration status.

In recent years there has been some research and develeolment into a plant focused keto diet for people with polycystic kidney disease.  This isn’t well established and very challenging to do and must be done under the guidance of a trained dietitian.  This topic will be discussed in a future article.

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In conclusion, while the ketogenic diet may offer some benefits for weight loss and blood sugar control, it may not be the best choice for people with kidney disease. The high fat and low carb nature of the diet can put a strain on the kidneys, which can lead to a variety of health problems such as renal failure, kidney stones and metabolic changes. It's important to consult with a healthcare professional before starting a keto diet if you have a history of kidney disease or are at risk of developing it.

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Author - Ruth Kander

Ruth Kander is a highly experienced dietitian with 26 years of service in both the NHS and private practice. She holds registrations with the British Dietetic Association and the Health and Care Professions Council. Ruth graduated from King’s College London in 1995 with an honors degree in Nutrition and a post-graduate diploma in Dietetics. Specializing in kidney medicine for the past 23 years, she currently works as a specialist kidney dietitian at a large London teaching hospital. Ruth has also been involved in several community projects, including healthy eating in schools and clinical governance in care homes. An accomplished lecturer, she has received awards for her education programs and patient care. Passionate about helping people with chronic kidney disease to be healthy and feel well, she is dedicated to providing support and guidance to help individuals make the best food choices for themselves.

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