RenalTracker Team
March 28, 2023

I hope you enjoy reading this blog post. It has been written and vetted by RenalTracker's team of kidney experts and researchers. The same team was awarded the KidneyX Prize organized by the American Society of Nephrology and HHS for pre-dialysis solution in Washington DC in 2019.   

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What is Keto Diet?

The goal of the ketogenic diet is to encourage your body to burn fat for energy by taking relatively few carbohydrates and replacing them with fat. Losing weight and reducing your risk of contracting certain diseases are two health advantages.

The low-carb, high-fat ketogenic diet, or keto diet for short, has many health advantages.

In fact, numerous studies demonstrate that this diet might aid in weight loss and health improvement.

Even the prevention of diabetes, cancer, epilepsy, and Alzheimer's disease may be helped by a ketogenic diet.

Side Effects of Keto Diet

When following a ketogenic diet, several things can occur that may not be desirable. 

The "keto flu" is a side effect of the ketogenic diet that usually manifests itself as poor energy, cognitive fog, and headaches.

Constipation is a common adverse effect of restricting carbs for many people. While a ketogenic diet includes low-carb vegetables, many people prefer to err toward consuming more fats like butter and bacon.

The following are additional negative impacts of a ketogenic diet:

  • Reflux

  • changes in the microbiota and gut health

  • abnormal readings for lipids

  • reduced blood sugar

  • reduced blood pressure

  • Nausea/vomiting

  • Diarrhea

  • Dehydration

Deficiencies in Nutrition

The diet has a strong emphasis on high-fat foods while severely limiting items high in carbohydrates such fruits, vegetables, legumes, and dairy. As a result, dietary deficits are more likely.

B vitamins (typically found in fortified whole grains and fruit), calcium (found in dairy and dark greens), vitamin D, and electrolytes like potassium can all contribute to these shortages.

Magnesium and the fat-soluble vitamins A and E were also shown to be depleted in kids on the therapeutic ketogenic diet.

Kidney illness and the keto diet can also cause calcium issues. The sources of fat may cause metabolic acidosis, which could increase the amount of calcium lost through urination. This is why kidney stones may be more common with a ketogenic diet.

While on a ketogenic diet for kidney illness, it's crucial to talk with your dietitian on the best supplement strategy to avoid vitamin deficiencies.

Keto Diet and Chronic Kidney Disease

Creatinine levels with the keto diet

In chronic renal disease, the body's naturally occurring waste product creatinine can accumulate over time. So how about creatinine levels and a ketogenic diet?

The keto diet and creatinine levels in people with chronic renal disease are not currently the subject of any research.

One study did compare the effects of low-carb/high-protein and low-fat diets on creatinine clearance. Nevertheless, the study only included obese adults free of any major illnesses, including kidney disease.

According to the findings of that particular study, healthy fat people did not negatively affect their GFR. Yet, the study also included the controversial sentence, "Further follow-up is needed to assess even longer-term impacts on renal function," in its conclusion.

Blood Pressure

While hypertension is one of the leading causes of renal disease, many individuals with the condition also struggle with blood pressure. This results in reductions in blood pressure as sodium shifts out of the body.

2020 research on rats showed that a ketogenic diet aggravated hypertension, leading to the advice to steer clear of a ketogenic diet for high blood pressure.

A review conducted in 2017 in the area of cardiovascular health discovered numerous research that suggested some potential reductions in blood pressure. This was supposed to be related to diet-related weight loss.

Insulin and Blood Sugar

Diabetes is the second most common cause of kidney damage, thus many people who already have the condition may need to take insulin.

Through the production of ketone bodies, the ketogenic diet changes the liver's basic function of regulating insulin. This implies that the amount of generated insulin may vary greatly.

In conclusion, you must consult your doctor and dietitian before beginning a ketogenic diet if you are already on insulin for type 1 or type 2 diabetes. The effectiveness of the keto diet for diabetes has been the subject of conflicting studies.

Food recommendations for CKD and Keto Diet

You might decide that a keto diet is something you'd like to try for yourself because it has some advantages. Here are some suggestions for adopting a keto diet for renal illness, though, if that is the case.

Concentrate on vegetables

Vegetables can still be consumed when following a low-carbohydrate diet. Here are some kidney-friendly low-carbohydrate veggie examples. But, depending on how well your kidneys are doing, potassium levels might need to be watched.


½ cup, 4g CHO


½ cup, 2g CHO

Green Cabbage

½ cup, 3g CHO


½ cup, <1g CHO



½ cup, 6g CHO

Choose healthy fats

Patients with CKD should eat high-quality fat sources while on a ketogenic diet. Choose fat sources that are kidney-friendly on a ketogenic diet to safeguard your kidneys:

  • Sunflower Oil
  • Safflower Oil
  • Avocado Oil
  • Sesame Oil
  • Canola Oil
  • Olive Oil

Prepare meals and snacks

One of the main obstacles to following a ketogenic diet is the need for a plan. Hence, following a ketogenic diet requires careful meal planning, food buying, and preparation (or any diet plan for that matter).

Make sure you have prepared and accessible healthy food. When you don't have the energy or time to prepare a meal, this might be a huge assist with preparation and hunger satisfaction.

Let your nephrologist know

Maintaining communication with your doctor about your health, including dietary changes, is crucial. Your renal specialist can request lab tests at convenient intervals to track your progress if you talk to them about your goal.

Based on those findings, they'll also be able to adjust your meds. Your doctor chooses the meds you're prescribed with the goal of protecting your kidneys.

Consult a renal dietitian

You will have access to a wealth of expertise to safely guide you through a keto diet for kidney illness by working with a renal dietician during this process. In addition to offering food and recipe suggestions to make it easier for you, your own renal dietician will assist you in keeping track of lab results and tracking your progress.

The Bottom Line

It always comes down to consuming less calories than you expend in order to lose weight. Focus on making wise decisions in all of the food groups while paying attention to portion sizes rather than adhering to a diet similar to the ketogenic diet or other low-carb eating plans. Not only will you be happy, but you'll also be healthier!

Always keep in mind that science requires skepticism and curiosity. This means that while we should all stay receptive to the results of future, high-quality scientific study on the keto diet, we shouldn't draw premature judgments. Collaborate with your medical professional and an experienced registered dietitian to help you go through and make sense of the research and choose the optimal eating plan for your needs.

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