The Keto Diet: Helping You Lose Weight or Hurting Your Kidneys? - Tidewater Physicians Multispecialty Group (2025)

Weight loss can be a difficult journey. With all the diets, nutrition plans, and weight loss programs out there, it’s difficult to know what’s healthy and backed by science. The ketogenic (keto) diet has helped many Americans lose weight; however, it may also contribute to an increased decline in kidney function for those with kidney disease.

The Keto Diet is characterized by very low-carbohydrate, modest in protein meals that focus heavily on fat intake. The aim of this diet is to induce “Ketosis “which generates ketone bodies that serve as an energy source as opposed to glucose. Keto diets have been used in the past especially in children to reduce the frequency of epileptic seizures. These days it has been promoted for weight loss, diabetes management, and liver disease. Research has shown a beneficial effect in short term but the overall long-term effect on health is still unknown.

On the keto diet, your body’s primary source of energy comes from burning fat rather than carbohydrates. Meaning, you aren’t consuming the vegetables and fruit required in a more traditional diet. Eating more protein and animal fats generates more acid in the blood. Acidosis increases the risk of developing painful kidney stones by lowering urine pH lowering urinary citrate which is protective and increasing urinary calcium excretion.

High Dietary acid load generated by the consumption of high animal fat and protein is associated with albuminuria (losing protein in urine) and the onset of chronic kidney disease. In addition to increasing your chances of developing chronic kidney disease, research has linked the keto diet to an increased decline in kidney function for those who already have chronic kidney disease. When you eat a high protein diet, the kidney must work harder because of increased blood flow to the filtrating unit of the kidney called Hyperfiltration, which leads to the progression of chronic kidney disease. A Keto diet potentially worsens metabolic acidosis, which is a common complication of chronic kidney disease, which ultimately affects bone and muscle health as well.

Those with or at risk for kidney disease can still find healthy alternative diets that can help with weight loss. For those with kidney disease, one of the best ways to maintain a healthy weight is to adopt a healthy lifestyle with balanced and portioned meals. This includes adequate amounts of protein, carbohydrates, fat, fiber, and other micronutrients. Additionally, restricting or reducing salt intake, particularly if you have high blood pressure, and ensuring proper hydration will alleviate stress on the kidneys. Those with advanced kidney disease might also want to pay extra attention to foods rich in potassium and phosphorus as your kidney may not be able to handle the load which causes complications.

“Consult with your physician or a nephrologist and go over lifestyle changes and dietary modification,” said board certified nephrologist, Sudip Ghimire, MD, FASN of TPMG Nephrology. Your dietary restrictions are different depending on your renal health. Those with healthy kidneys might not need the same nutrients as those with an advanced case of kidney disease.

Your weight loss journey shouldn’t negatively affect your health. Talk with a TPMG nephrologist today, and discuss foods that are beneficial for kidney health like the renal diet.

The Keto Diet: Helping You Lose Weight or Hurting Your Kidneys? - Tidewater Physicians Multispecialty Group (2025)

FAQs

Does a keto diet affect your kidneys? ›

Some complications associated with the ketogenic diet include renal impairment and decreased bone density [1]. Renal dysfunction associated with the ketogenic diet has been reported in individuals with underlying kidney disease exposed to high protein.

What is the best way to lose weight with kidney disease? ›

6 Tips for Losing Weight with Kidney Disease
  1. Choose fresh foods. Fresh foods like vegetables and fruits are healthier options than processed and fast foods. ...
  2. Read nutrition labels. ...
  3. Monitor your protein intake. ...
  4. Consider a plant-based protein diet. ...
  5. Limit your calorie intake. ...
  6. Add exercise to your daily routine.

Is BHB safe for kidneys? ›

BHB/citrate confers benefits via multiple mechanisms, increases creatinine and citrate excretion, and normalizes mineral excretion. BHB and citrate are widely available and generally recognized as safe compounds and, in combination, exhibit high promise for supporting kidney health in polycystic kidney disease.

What are the side effects of a keto diet? ›

The most common side effects include constipation, fatigue, dizziness, weakness, nausea, diarrhea, and stomach pain. The long-term safety of the ketogenic diet in adults is unknown. It is important to ensure any diet remains balanced and contains nutrient-rich foods.

Is weight loss hard on the kidneys? ›

While losing weight can help reduce your risk of chronic kidney disease and decrease its progression, rapid weight loss can be dangerous. According to a recent study, individuals who lose weight quickly with chronic kidney disease tend to have a disproportionately higher loss of lean body mass than loss of fat mass.

What is the best diet for a person with kidney disease? ›

The DASH Diet is rich in fruits, vegetables, low-fat dairy products, whole grains, fish, poultry, beans, seeds, and nuts. It is low in salt and sodium, added sugars and sweets, fat and red meats.

How do I protect my kidneys on a keto diet? ›

Additionally, restricting or reducing salt intake, particularly if you have high blood pressure, and ensuring proper hydration will alleviate stress on the kidneys.

What are the worst foods for kidney function? ›

1. Salt
  • Canned soups.
  • Processed meats like lunch meats, hot dogs, sausages.
  • Frozen pizza.
  • Frozen dinners.
  • Snack foods like chips, crackers, pretzels.
  • Condiments like ketchup, BBQ sauce, soy sauce.
  • Salad dressing.
  • Pickled foods like pickles, olives, beets.

What is the best thing to drink for your kidneys? ›

We'll go through five drinks and juices that can help your kidneys function at their best.
  1. Water. About 60% to 70% of your body is water. ...
  2. Low-fat milk. ...
  3. Coffee. ...
  4. Green tea. ...
  5. Unsweetened cranberry juice.

What supplements are hardest on the kidneys? ›

Some supplements that you should avoid if you have kidney disease include supplements with:
  • Chromium picolinate.
  • Creatine monohydrate.
  • Germanium.
  • L-lysine.
  • Larrea tridentate.
  • Pausinystalia yohimbe.
  • Salix daphnoides.
  • Thunder god vine.
Nov 3, 2022

What is the best supplement for the kidneys? ›

By providing essential nutrients, some supplements may help enhance kidney function and reduce the risk of vitamin or mineral deficiencies that people with kidney disease are at greater risk for. Vitamin D, iron, B vitamins, and magnesium are a few supplements that can help kidney health.

What are the side effects of taking BHB? ›

Some people might have stomach upset, diarrhea, constipation, and stomach pain. These side effects are more likely to happen when very high doses are used. There isn't enough reliable information to know if BHB is safe when more than one dose is used. When applied into the eye: BHB is possibly safe.

Who should not do keto? ›

In particular, it's not recommended for pregnant and breastfeeding women or those with certain health conditions, like IBS, osteoporosis, or kidney problems. The keto diet can improve markers of health — such as cholesterol and other blood fat levels — in people with obesity without major side effects.

What organ does keto affect? ›

High-fat, low-carb regimen stresses out cells in heart, kidneys, brain, and liver, but effects may be reversible. Many influencers, athletes, and regular folks swear by ketogenic diets—skimping on carbs and feasting on fats to quickly shed pounds and improve their metabolism.

What medications should not be taken with keto? ›

Many anticonvulsant medications originally designed to control epilepsy (seizures) are also prescribed by psychiatrists for mood swings, insomnia, or anxiety. The ones most likely to behave strangely when embarking on a ketogenic diet are Depakote (valproate), Zonegran (zonisamide), and Topamax (topiramate).

What organs does ketosis affect? ›

This shift involves increasing fatty acid oxidation and production of ketones in the liver as an alternate energy source for the brain as well as the skeletal muscles, heart, and kidney. Low levels of ketones are always present in the blood and increase under circumstances of low glucose availability.

Does a low carb diet improve kidney function? ›

Researchers from Mount Sinai School of Medicine have for the first time determined that the ketogenic diet, a specialized high-fat, low carbohydrate diet, may reverse impaired kidney function in Type 1 and Type 2 diabetes.

What are the symptoms of kidney ketosis? ›

You have ketones in your urine and can't reach your health care provider for advice. You have many symptoms of diabetic ketoacidosis. These include excessive thirst, frequent urination, nausea and vomiting, stomach pain, weakness or fatigue, shortness of breath, fruity-scented breath, and confusion.

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