The Ketogenic Diet and Kidney Disease

author avatar Dr. Eric Berg 05/14/2024

The ketogenic diet, or keto for short, has exploded in popularity as a quick fix for shedding pounds and getting healthy. But like any diet that severely limits what you can eat, there are potential risks – especially to your kidneys.

As someone who's been tempted to try keto myself, I decided to do some digging and uncover the truth behind the hype. What I discovered might just make you think twice before jumping on the keto bandwagon.

Understanding the Ketogenic Diet and Kidney Health

The ketogenic diet has gained popularity in recent years as a weight loss and metabolic health strategy. But what exactly is this high-fat, low-carb approach, and how does it impact kidney function?

Let's dive into the basics of the keto diet and explore its potential effects on kidney health.

The Ketogenic Diet: A Low Carb, Not High Protein Approach

One common misconception about the ketogenic diet is that it's a high-protein plan. In reality, the keto diet is a high-fat, moderate-protein, and very low-carbohydrate approach.

Imagine your body as a hybrid car that can run on two types of fuel: glucose from carbs or ketones from fat. Ketosis is like flipping the switch to make fat your body's primary gas station. Getting there isn't easy though - you'll need to cut out most carbs and fill up on fats instead.

Carbohydrates vs. Fat: Effects on Kidney Function

So, how do these macronutrient choices impact the kidneys? High carbohydrate intake, especially from refined sources like sugar and processed grains, can contribute to insulin resistance and metabolic dysfunction.

If you're not careful, long-term adherence to a ketogenic diet can place undue strain on your kidneys, elevating your chances of facing chronic kidney disease down the road.

On the flip side, a properly structured keto approach – one that emphasizes beneficial fats and cuts back on carbs – may work to improve your body's insulin response and reduce inflammation, two factors that can play a role in maintaining healthy kidneys.

Ketoacidosis vs. Ketosis: Understanding the Difference

It's crucial to distinguish between the beneficial state of nutritional ketosis and the dangerous condition of ketoacidosis. Ketoacidosis is a medical emergency that can occur in individuals with type 1 diabetes or severe insulin deficiency.

In this state, the body produces excessive ketones, leading to a dangerous drop in blood pH.

Nutritional ketosis, on the other hand, involves a controlled and moderate production of ketones, which can be safely used for energy without negatively impacting blood pH or kidney function.

Human kidney illustration

The Protective Role of Diet in Kidney Health

Beyond the macronutrient ratios of the ketogenic diet, specific food choices within this framework can play a protective role in kidney health. Let's explore a couple of key factors.

The Importance of Potassium from Vegetables

Potassium, an essential mineral abundant in many vegetables, acts as a natural diuretic and helps balance fluid levels in the body. Adequate potassium intake can help reduce blood pressure and decrease the risk of kidney stones.

On a ketogenic diet, it's important to prioritize low-carb, potassium-rich vegetables like leafy greens, avocados, and Brussels sprouts to support kidney function.

Risks of Uric Acid Stones and Gout on Keto

One potential concern with the ketogenic diet is the risk of developing uric acid stones and gout. This risk can increase if the diet is not well-planned and lacks adequate vegetable intake.

Uric acid stones form when urine becomes too acidic, which can occur with high intake of animal proteins and low consumption of alkalizing vegetables. To mitigate this risk, it's crucial to include a variety of low-carb vegetables in your keto meal plan and stay well-hydrated.

External Factors Influencing Kidney Disease

Sure, we're all responsible for what we put on our plates, and that matters for kidney health. But there are also bigger forces at play - things like environmental factors and overall dietary patterns - that may be causing kidney disease to become more common.

GMO Foods and Glyphosate: A Growing Concern

The increasing prevalence of genetically modified (GMO) foods and the widespread use of glyphosate, a controversial herbicide, have raised concerns about their potential impact on human health, including kidney function.

Some studies suggest that glyphosate exposure may be linked to an increased risk of CKD, although more research is needed to establish a definitive causal relationship.

To minimize potential risks, individuals following a ketogenic diet may choose to prioritize organic, non-GMO foods whenever possible.

Strategies for Kidney Protection on a Ketogenic Diet

Embarking on a ketogenic diet journey? Don't forget about your kidneys. With a few smart moves, you can keep them in tip-top shape while you navigate this new way of eating.

Intermittent Fasting and Kidney Health

Intermittent fasting (IF) and a ketogenic diet? Together, they're like a power couple for your kidneys. IF works to lower inflammation, improve your body's response to insulin, and kick-start cellular repair through autophagy – all of which can give your kidney health a serious boost.

Giving your body a break from digesting food through intermittent fasting can help ease the burden on your kidneys, allowing them to do their job of detoxing more efficiently.

But before you jump into any new way of eating, it's always smart to check with your doctor first, especially if you've had kidney problems in the past.

The Role of High Vegetable Consumption

Emphasizing a wide variety of low-carb, nutrient-dense vegetables is crucial for kidney health on a ketogenic diet. Aim to fill at least half of your plate with non-starchy vegetables at each meal.

This not only provides essential vitamins, minerals, and fiber but also helps maintain a healthy acid-base balance in the body, reducing the risk of kidney stones and other complications.

Avoiding GMO Foods for Optimal Kidney Function

To further support kidney health, consider minimizing your exposure to GMO foods and glyphosate. Opt for organic produce whenever possible, and choose grass-fed, pasture-raised animal products to reduce your intake of potentially harmful substances.

Reading labels carefully and prioritizing whole, unprocessed foods can go a long way in promoting overall health and protecting your kidneys while following a ketogenic diet.

Kidney Conundrum

Navigating the potential risks of a ketogenic diet often brings up concerns about kidney health. While the diet's high-fat, low-carb approach can be effective for weight loss and managing certain medical conditions, some worry it might contribute to kidney issues.

However, current research indicates that for most people with healthy kidneys, a well-formulated keto diet does not pose significant risks. It's crucial to stay hydrated and maintain balanced electrolytes to support kidney function.

Interestingly, this electrolyte balance also ties into understanding what causes a charley horse—a sudden, painful muscle cramp often linked to electrolyte imbalances, particularly deficiencies in potassium, calcium, or magnesium.

Ensuring adequate intake of these minerals can help prevent both kidney-related concerns and the discomfort of charley horses while on a keto diet.


So, does the ketogenic diet cause kidney disease? The answer is: it depends. While a well-planned keto diet can be safe for most healthy individuals, those with pre-existing kidney issues or risk factors should proceed with caution.

The key is to focus on high-quality, nutrient-dense foods, stay hydrated, and monitor your kidney function regularly.

Partner with a healthcare expert to safely enjoy the benefits of a ketogenic diet while keeping your kidneys happy and healthy. Treat your body like the temple it is, and it'll keep you going strong for the long haul.

Healthy Keto Guide for Beginner

FREE Keto Diet Plan