The ketogenic diet, known for its very low carbohydrate and high-fat content, has become popular for managing type 2 diabetes (T2D) and obesity. Researchers have been exploring its effects on various health conditions, including chronic kidney disease (CKD), but the evidence is still limited. In a recent article, scientists mined a variety of studies to learn about the keto diet’s impact on T2D, obesity, and CKD.*

What the Researchers Did

Scientists looked at a range of studies to understand how the keto diet affects people’s health. In each of the studies, participants followed a keto diet, which means eating:

• More than 70% of their daily calories from fat, 
• 6-20% from protein, and 
• Less than 10% from carbs.

The studies included short-term trials (less than a year) to see the immediate effects and long-term trials (more than a year) to understand if people could stick with the diet and what happened over time. 

Researchers measured and tracked the participants’:

• Weight loss, 
• Blood sugar levels, 
• Kidney function, and 
• Risks for problems like kidney stones and metabolic acidosis (a condition where the body produces too much acid).

What They Found

The researchers discovered that, in the short term, people on the keto diet often lost weight and saw improvements in their blood sugar levels. These benefits were most noticeable in people who could stick to the diet’s rigid parameters. 

In the long term, however, the benefits were less clear. Many people found it hard to keep up with the strict carb limits, which reduced the diet’s effectiveness over time.

When it comes to kidney health, short-term studies didn’t show any harm to kidney function, but scientists are concerned about long-term effects. The keto diet often includes a lot of saturated fats from animal products and not enough fiber from plants. This imbalance can:

• Cause metabolic acidosis, which can worsen kidney function, and
• Lead to higher levels of urinary oxalate, increasing the risk of kidney stones.

What It Means 

While the keto diet can offer significant short-term benefits for weight loss and glycemic control, the study authors conclude, its potential for kidney damage, metabolic acidosis, and kidney stones makes it important for people with CKD to consider safer dietary options. 

A plant-based diet, rich in fiber and healthy fats, they say, might be a better choice. Plant-based diets involve focusing on fats from plants, such as:

• Avocados,  
• Nuts,
• Seeds, and 
• Oils such as olive and canola oil.

This kind of diet avoids many of the risks associated with the keto diet and provides essential nutrients that can help protect kidney health.

Plant-based diets provide essential nutrients, are healthier for kidneys, and are less likely to raise harmful cholesterol levels. Including plant-based proteins and fibers can also help maintain better overall health.

*Joshi, S., Shi, R., and Patel, J. (2024, January). Risks of the ketogenic diet in CKD – the con part. Clinical Kidney Journal. Retrieved from https://academic.oup.com/ckj/article/17/1/sfad274/7379589 

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