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" Ketogenic diet can damage the kidneys" You may have heard such doctor warnings.
Eating too much meat with a ketogenic diet will be detrimental to the kidneys.
The relationship between protein and kidney health is very complicated, and we have shared many articles before.
First of all: Protein is very important, muscle synthesis requires protein, and various life activities also require amino acid to complete.
However, many experts say that high protein can damage the kidneys, and patients with chronic kidney disease should eat less protein.
The question is, is ketogenic a high-protein diet? Will it damage kidney health?
Abroad, Dr. Thomas Weimbs, a famous kidney disease researcher, has been helping many people with various kidney diseases with a ketogenic diet.
Today, in this article, we can take a look at his explanation.
What is chronic kidney disease (CKD)
diabetes , hypertension and atherosclerosis (arthritis sclerosis) are all familiar diseases, but you may not know that they are also the main diseases that causes chronic kidney disease.
→CKD?
Chronic kidney disease, also known as CKD, is now a global public health burden. The global prevalence of chronic kidney disease (CKD) is 8-16%, and is still increasing.
Chronic kidney disease is a precursor to many diseases. Although the symptoms are not too serious, it will increase the risk of heart attacks and strokes . In severe cases, it may even develop into renal failure .
In the late stage, it is easy to cause renal failure. Many diabetics spend high hemodialysis fees.
Everyone knows that the kidney is a filtering organ, which removes liquid waste from the blood. CKD is clinically manifested by a decrease in glomerular filtration rate (GFR), and urine protein excretion increases .
Injury of renal podocytes and proximal renal tubular cells leads to loss of urine protein, which in turn induces renal tubular apoptosis, resulting in renal tubular atrophy and even renal failure.
Chronic kidney disease, will also be accompanied by many complications, including increased cardiovascular mortality, acute kidney injury, cognitive decline, mineral loss, anemia and fractures.
The relationship between nutrition and kidney disease?
Different nutrients have different effects on kidney health. People with CKD may need to control specific ingredients in their diet to maintain balance of electrolytes, minerals and body fluids in their bodies.
→Protein
Protein is one of the most basic and important nutrients, which is crucial for maintaining body tissues, certain hormones and antibodies, and participate in the necessary molecular transportation in the body.
However, for patients with kidney disease, excessive protein may be a burden on the kidneys of .
Because their glomerular function declines, excessive protein can cause waste accumulation in the blood.
On the other hand, the protein intake should not be too low, otherwise it may lead to problems with basic physiological activities, and bone construction and muscle synthesis are affected.
→Minitic calcium and phosphorus
Calcium and phosphorus are generally not put together. Everyone is familiar with the importance of calcium's bones, but they rarely hear about phosphorus.
However, in patients with CKD, the balance of calcium and phosphorus is very important.
Calcium and phosphorus are the key to preventing osteoporosis . In addition, calcium is involved in cell signaling, wound coagulation, muscle activity (contraction) and nerve function; while phosphorus is involved in PH homeostasis and energy production.
Under normal circumstances, calcium and phosphorus are generally balanced. As renal function deteriorates, calcium is also lost while urine protein is lost, resulting in an increase in the phosphorus content in the blood and thus weakening of the bones.
For patients with CKD, either enough food to supplement calcium or it is necessary to limit phosphorus intake.
However, foods rich in phosphorus are usually rich in calcium, so after limiting the intake of phosphorus, calcium and need to be supplemented separately with vitamin D and vitamin K2.
→Sodium potassium balance
Sodium potassium balance is an important part of kidney function, which is also the key to the kidney affecting blood pressure. Therefore, patients with hypertension usually adopt a low-salt or low-sodium diet.
sodium usually exists in the form of salt ( sodium chloride ), but many salt substitutes contain potassium while controlling sodium, and also regulate the sodium-potassium balance.
If renal function is hindered, sodium levels will be adversely regulated. Excessive sodium can cause fluid accumulation, swelling, increased blood pressure and heart strain.
CKD patients will also reduce their sodium intake, but pay attention to the product of potassium instead of sodium, which may lead to hyperkalemia (hyperkalemia) , and may also lead to abnormal and dangerous heart rhythm.
Acidic blood and acidic urine
Thomas Weimbs When introducing his theory, he mentioned the importance of Acidic blood and acidic urine , which are important indicators for judging kidney health.
→Metabolic acidosis
What is metabolic acidosis? When the kidneys and lungs cannot maintain the balance of the body's pH, acidosis will occur.
This is because many processes in the body produce acid, which is generally caused by decreased kidney function, so people with kidney damage are more likely to experience acidosis.
Metabolic acidosis mainly includes acid accumulation and alkali loss .
For example, diabetic acidosis, lactic acidosis and renal tubular acidosis are all due to the accumulation of acidic substances, and perchloric acidosis is due to the loss of sodium bicarbonate .
Metabolic acidosis is a common manifestation of CKD. In turn, as the acid accumulates, renal function decreases, which will worsen CKD.
→What is the effect of low urine pH
People with metabolic acidosis are usually very ill and are often sent to the emergency room.
urine pH is a test for routine urine analysis and is usually used to evaluate the risk of kidney stones . Too low urine pH can reflect the amount of acid in food and renal function.
study found that patients with impaired renal function or kidney disease may have lower urine pH.
is not only a kidney disease, but some other diseases will also show a lower urine pH value, and often end up with kidney disease. For example, hyperglycemia and diabetes .
The relationship between protein, calories and kidney health
Neutologists usually recommend that patients with CKD limit protein intake, especially in the third stage of kidney disease development and later. Will protein affect renal function?
→The protein is too high, which aggravates CKD
We all believe that protein is a particularly good nutrient and should not damage organ functions. However, for patients with severe kidney disease, excessive protein can really damage kidney function .
First of all, proteins are highly complex macromolecules that may induce vasodilation, glomerular hypertension and hyperfiltration into the renal artery, which will aggravate CKD.
In addition, the accumulation of end products of protein catabolism (such as p-cresol sulfate, indodyl sulfate and trimethylamine ) will aggravate the risk of uremia .
And in different stages of kidney disease, protein intake is not static. For example, the protein problem of phase 1-2 of CKD is not very big, but starting from phase 3, it should be appropriately restricted.
→Ketogenic=High protein=High calories?
Many people will have a question when they see this: the ketogenic diet also consumes a lot of protein. Will it worsen the symptoms of CKD?
and a pure meat diet, so there is more protein.
In fact, this issue should really be discussed seriously. First of all, is ketogenic = high-protein = high-calorie diet?
If you have learned about ketogenic, you should know that the core of the ketogenic diet is low-carb , and eat more high-quality fats, mainly to maintain enough energy and a feeling of fullness.
is often a moderate requirement for protein intake. In order to avoid protein production of gluconeogenesis , should be used to reduce protein as much as possible.
CKD usually requires less than 0.6-0.8g/KG/day, that is, for an adult with 60KG, it is best not to have a daily protein intake of more than 0g.
g protein does not mean 1g meat. Beef, chicken, fish, shrimp, and pork are similar. Every 1 liang of li contains about 7 grams of protein, while eggs are less than 5g.
Low-calorie ketogenicity, improving kidney health
In China, there is also a nephrologist, director Wang Tong of of Tianjin First Central Hospital. She supports a low-carbon ketogenic diet. For patients with severe kidney disease, it is necessary to strictly control calorie .
The patients she contacted were patients with advanced diabetes and had renal dialysis . Some patients had improved their kidney function under her intervention.
I have also seen some foreign studies saying that ketogenic diet harms the health of the kidneys. If you do it behind the scenes, ketogenic is easy to harm the kidneys. As long as there is too much protein or excessive calories, it may be harmful to patients with advanced diabetes.
If nephropathy patients develop ketones, they must strictly control proteins and total calories and supplement sufficient nutrients.
A study once found that ketogenic with low calories and moderate amounts of protein is a safe and effective method for kidney health.
We have shared before that diabetic patients may recover their kidney function by using low-carbon diet .
is different from my previous opinion. Now I think both calories and protein are important. If you don’t control calories, you will have high protein in the long run, which may be risky to the kidneys.
The key skinny dragon says
So, the question is, can people with poor kidneys develop ketones?
The answer is: Yes, but to control protein and total calories, you also need to cooperate with exercise.
For older chronic patients, the 10-word motto of Skin Dragon must be kept in mind:
Control carbohydrate, calories, and precise nutrition.
If you don’t have any basic nutrition , then don’t ketogenic. It is very likely that the protein exceeds the standard and the calorie exceeds the standard.
However, other methods cannot save you, you may only be able to do dialysis every day, and it is difficult to maintain.
So, I still recommend that you learn more, sometimes it can really help you.
For the amount of protein (lean meat, eggs, etc.) , if you do not have exercise, do not have muscle mass , it is not recommended to eat more.
Ordinary people eat too much, which may also lead to risks such as high uric acid and strong appetite.
People with kidney dysfunction , in addition to protein, carbohydrate needs to be controlled, because insulin resistance is also a trigger.
There is another saying that too much ketone in the blood can cause ketoacid poisoning , which is also a classic rumor. Because ketotoxicity usually occurs in sugar type 1, because it does not have insulin secretion function.
