The REAL Cause of Chronic Kidney Disease and Polycystic Kidney Disease

Dr. Eric Berg 07/09/2024

Chronic kidney disease affects millions worldwide, and finding effective ways to manage it is crucial. As someone who's spent years researching and working with patients dealing with kidney issues, I've seen firsthand how diet can play a pivotal role in kidney health.

Recently, there's been growing interest in the potential benefits of a ketogenic diet for kidney disease. This low-carb, high-fat approach has shown promise in various health conditions, but its effects on kidney function are particularly intriguing.

Understanding Chronic Kidney Disease and Its Challenges

Chronic kidney disease (CKD) is a complex condition that affects the kidneys' ability to filter waste and excess fluids from the blood. It's often a silent disease, progressing slowly over time without noticeable symptoms until it reaches advanced stages.

The primary causes of CKD include diabetes, high blood pressure, and certain genetic conditions.

One particularly challenging form of kidney disease is polycystic kidney disease (PKD). This genetic disorder causes fluid-filled cysts to grow in the kidneys, eventually impairing their function.

Until recently, treatment options for PKD were limited, with patients often facing the prospect of dialysis or kidney transplantation.

Selection of low-carb foods

The Ketogenic Diet: A Potential Game-Changer for Kidney Health?

The ketogenic diet, characterized by its high fat, moderate protein, and very low carbohydrate content, has been gaining attention in the medical community for its potential therapeutic effects.

While it's best known for its use in epilepsy treatment and weight loss, recent research has shed light on its possible benefits for kidney health.

Ketogenic Diet and Polycystic Kidney Disease

A groundbreaking study published in 2019 revealed some exciting findings regarding the ketogenic diet and PKD. The research, conducted on mice with PKD, showed that a ketogenic diet could actually halt and even reverse the progression of cystic growth in the kidneys.

This discovery was particularly significant because it offered a potential non-toxic solution to a condition that previously had few treatment options. The study found that the cysts in PKD are not only glucose-absorbing but are actually dependent on glucose for growth.

By drastically reducing carbohydrate intake, the ketogenic diet effectively starves these cysts of their primary fuel source, which is glucose. A diet high in fat could potentially be beneficial for those suffering from PKD.

Ketogenic Diet and Kidney Stones

Another concern often associated with kidney disease is the formation of kidney stones. Interestingly, the same study found that a ketogenic diet could reduce the risk of kidney stones, provided that the diet is low in oxalates.

Oxalates, found in foods like spinach, almonds, and chocolate, can contribute to kidney stone formation.

To minimize this risk while on a ketogenic diet, it's crucial to:

Avoid high-oxalate foods.
Stay well-hydrated (aim for at least 2.5 liters of fluid per day).
Ensure adequate intake of minerals like calcium and magnesium.

How the Ketogenic Diet May Benefit Kidney Function

The potential benefits of a ketogenic diet for kidney disease extend beyond just PKD. Here are several ways this dietary approach might support kidney health:

Blood Sugar Regulation

One primary way the ketogenic diet may benefit kidney function is through its effect on blood sugar levels. By drastically reducing carbohydrate intake, the diet helps stabilize blood glucose and improve insulin sensitivity.

This is particularly important for individuals with diabetic nephropathy, as better glycemic control can slow the progression of kidney damage. This is possible because a ketogenic diet focuses on carbohydrate restriction.

Reduction of Inflammation

Chronic inflammation is a significant factor in the progression of kidney disease. The ketogenic diet has been shown to have anti-inflammatory effects, potentially helping to protect kidney tissue from further damage.

This anti-inflammatory action is thought to be partly due to the production of ketone bodies, which have been found to have direct anti-inflammatory properties. Ketone bodies are an alternative energy source.

Weight Management

Obesity is a risk factor for kidney disease and can exacerbate existing kidney problems. The ketogenic diet has proven to be an effective tool for weight loss, which can indirectly benefit kidney health by reducing the overall burden on these vital organs.

People who are overweight or obese can especially benefit from this.

Blood Pressure Control

High blood pressure is both a cause and a consequence of kidney disease. Some studies have suggested that a ketogenic diet may help lower blood pressure, potentially providing another avenue for kidney protection.

If you have high blood pressure, talk to your doctor to find out if the ketogenic diet is right for you.

The Role of Ketones in Kidney Health

When following a ketogenic diet, the body enters a state called ketosis, where it primarily burns fat for fuel instead of carbohydrates. This process produces ketones, which serve as an alternative energy source for the body.

Interestingly, recent research has shown that ketones themselves may have protective effects on the kidneys.

Ketones appear to have antioxidant properties and may help reduce oxidative stress in kidney cells. They've also been found to inhibit a protein called mTOR, which plays a role in the growth of cysts in PKD and the progression of other forms of kidney disease.

Implementing a Kidney-Friendly Ketogenic Diet

While the potential benefits of a ketogenic diet for kidney disease are promising, it's crucial to approach this dietary change carefully, especially if you have existing kidney issues. Here are some key considerations:

Protein Intake

Traditional ketogenic diets are often high in protein, which can be problematic for some individuals with kidney disease. It's important to work with a healthcare provider to determine the appropriate protein intake for your specific situation.

Too much protein intake can put a strain on your kidneys, especially if you already have diseased kidneys.

Electrolyte Balance

The ketogenic diet can affect electrolyte balance, which is already a concern in kidney disease. Careful monitoring and possible supplementation of electrolytes like sodium, potassium, and magnesium may be necessary. These electrolytes get depleted during ketosis.

Nutrient Density

When following a ketogenic diet for kidney health, focus on nutrient-dense foods that provide essential vitamins and minerals without overloading the kidneys. Some excellent choices include:

Leafy green vegetables (low in oxalates).
Fatty fish rich in omega-3s.
Avocados.
Olive oil.
Nuts and seeds in moderation.

Hydration

Proper hydration is crucial for kidney health, especially on a ketogenic diet. Aim to drink plenty of water throughout the day to support kidney function and help prevent kidney stones.

You should especially increase your fluid intake on a ketogenic diet because of the diuretic effect.

Combining Ketogenic Diet with Other Kidney-Supportive Strategies

While the ketogenic diet shows promise for kidney health, it's most effective when combined with other supportive strategies. Here are some additional approaches that may complement a ketogenic diet for kidney disease:

Intermittent Fasting

Time-restricted eating, a form of intermittent fasting, has shown potential benefits for kidney health. The 2019 study on PKD found that intermittent fasting had similar effects to the ketogenic diet in slowing cyst progression and reducing associated fibrosis.

The rapamycin complex has also been found to mimic some of the effects of a ketogenic diet.

Targeted Supplementation

Certain supplements may support kidney health when used alongside a ketogenic diet. These include:

Curcumin: Known for its anti-inflammatory properties.
Resveratrol: May help reduce oxidative stress.
EGCG (from green tea): Potential mTOR inhibitor.
Quercetin: Antioxidant with potential kidney-protective effects.
Berberine: May help improve insulin sensitivity and reduce inflammation.

Always consult with a healthcare provider before starting any new supplement regimen, especially if you have kidney disease.

Three different faces of a woman

Stress Management

Chronic stress can negatively impact kidney function. Incorporating stress-reduction techniques like deep breathing exercises can complement the benefits of a ketogenic diet for kidney health.

These stress management techniques are beneficial for improving global outcomes for those with chronic kidney disease.

Potential Risks and Considerations

While the ketogenic diet shows promise for kidney health, it's not without potential risks, especially for those with existing kidney issues. Some concerns to be aware of include:

Risk of nutrient deficiencies if the diet is not well-planned.
Potential for increased acid load on the kidneys. Increased acid load can be especially harmful to those with advanced CKD.
Possible exacerbation of kidney stones in some individuals.
Interactions with certain medications used to treat kidney disease.

It's crucial to work closely with a healthcare provider and a registered dietitian experienced in both kidney disease and ketogenic diets before making any significant dietary changes.

Conclusion

The relationship between the ketogenic diet and kidney disease is a fascinating area of ongoing research.

While early studies show promise, particularly for conditions like polycystic kidney disease, more research is needed to fully understand the long-term effects and optimal implementation of a ketogenic diet for various forms of kidney disease.

There have been reported improvements for those on a ketogenic diet. For those considering a ketogenic approach to managing kidney health, it's essential to approach this dietary change thoughtfully and under professional guidance.

The potential benefits of improved blood sugar control, reduced inflammation, and even the possibility of slowing cyst growth in PKD are exciting prospects.

However, the complexities of kidney disease require a personalized approach that takes into account individual health status, medication regimens, and nutritional needs. It is important to look at the estimated glomerular filtration rate of the patient.

As we continue to learn more about the intricate connections between diet and kidney health, the ketogenic diet may prove to be a valuable tool in our arsenal against chronic kidney disease.

By combining this dietary approach with other kidney-supportive strategies and working closely with healthcare providers, individuals with kidney issues may find new hope in managing their condition and improving their overall quality of life.

Clinical practice should reflect these advancements in hopes of improving global outcomes for patients.