How might Low Carb and Ketogenic Diets affect the Progression of Chronic Kidney Disease?

Abstract

Background: Obesity, an ever-increasing cause for deaths in the American population, often leads to complications such as Type II Diabetes Mellitus. Both obesity and diabetes predispose to renal disease, which can be ameliorated by treatment of both disorders. Ketogenic and Low Carb diets (KD/LCD) can lower blood sugar of T2DM patients and accelerate weight loss. Diet is a potential factor in slowing the rate of decline in kidney function. Yet, high diet acid loads, as from keto acid, may promote renal damage. Here, we evaluate existing studies on the benefits or harms of KD/LCD on factors associated with renal disease progression. 
 Methods: Reviews and analysis of existing studies on chronic kidney disease and Ketogenic diets. We analyzed eGFR, the measure of the rate of change in decline of renal function to infer the effects of Ketogenic and Low Carb diets.
 Results: Nine of the 22 papers reviewed were analyzed. Studies included from 18 to 1797 participants and included healthy subjects, those with diabetes and /or obesity, and those with normal renal function or moderate kidney failure (eGRF ranged from 94 ± 12 mL/min/ to 40 ml/min/1.73m2). Study duration ranged from 5 weeks to 6 years. Several studies demonstrated improvements, including decreases in serum creatinine, urinary albumin, weight loss, and eGFR.
 Conclusions: Renal function improved in shorter studies of diabetics who demonstrated weight loss. Longer studies or those in nondiabetics demonstrated no change in renal function.