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Nephrolithiasis associated with the ketogenic diet
1Section of Urology, Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
The Journal of Urology
|July 14, 2000
Summary
The ketogenic diet can cause kidney stones in children due to metabolic changes. Early detection and treatment, including fluid and citrate therapy, are crucial for managing this complication.
Area of Science:
- Pediatric Nephrology
- Metabolic Disorders
- Dietary Therapeutics
Background:
- The ketogenic diet is a well-established therapy for seizure disorders, used for over 70 years.
- Nephrolithiasis (kidney stones) is a recognized complication, with reported rates up to 10% in patients on this diet.
- Limited literature exists on the specific characteristics and management of kidney stones associated with the ketogenic diet.
Purpose of the Study:
- To report on the nature and treatment of nephrolithiasis in children adhering to a ketogenic diet.
- To detail metabolic and urine abnormalities observed in pediatric patients with ketogenic diet-induced kidney stones.
Main Methods:
- Retrospective analysis of 4 pediatric patients with nephrolithiasis on a ketogenic diet.
- Description of stone analysis, treatment modalities (shock wave lithotripsy, fluid liberalization, oral citrate), and metabolic evaluations.
Main Results:
- Three calcium stones and one ammonium urate stone were identified.
- Metabolic abnormalities included hypercalciuria (3 patients), elevated urinary uric acid (2 patients), hypocitruria (1 patient), and acidosis (3 patients).
- One patient discontinued the ketogenic diet due to recurrent stone formation.
Conclusions:
- The ketogenic diet can induce metabolic changes that heighten the risk of kidney stone formation in children.
- Urologists and clinicians should be vigilant for this potential complication.
- Fluid liberalization and oral citrate are recommended for prophylaxis against ketogenic diet-associated nephrolithiasis.