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Published on: February 9, 2021

Kidney stones and the ketogenic diet: risk factors and prevention

Amitha Sampath1, Eric H Kossoff, Susan L Furth

  • 1School of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Journal of Child Neurology
|July 11, 2007
PubMed

Insights

The ketogenic diet for epilepsy can cause kidney stones in children. Oral potassium citrate significantly reduced stone prevalence, suggesting its preventative role in this population.

Area of Science:

  • Pediatric Neurology
  • Nephrology
  • Metabolic Disorders

Background:

  • The ketogenic diet is an established therapy for intractable epilepsy in children.
  • Kidney stones are a known complication of the ketogenic diet.
  • Understanding risk factors and preventative strategies is crucial for long-term adherence.

Purpose of the Study:

  • To investigate the incidence and risk factors of kidney stones in children on the ketogenic diet.
  • To evaluate the efficacy of urine alkalinization with potassium citrate in preventing kidney stones.

Main Methods:

  • A retrospective cohort study of 195 children on the ketogenic diet for intractable epilepsy (2000-2005).
  • Comparison of children with and without kidney stones regarding demographics, urine markers, and potassium citrate use.
  • Statistical analysis to identify correlations and treatment effects.

Main Results:

  • Thirteen children (6.7%) developed kidney stones.
  • Oral potassium citrate significantly decreased stone prevalence (3.2% vs 10.0%, P = .049).
  • No significant correlation found with age or carbonic anhydrase inhibitors; a trend towards hypercalciuria was noted (P = .08).

Conclusions:

  • Kidney stones remain a concern in pediatric ketogenic diet therapy.
  • Oral potassium citrate demonstrates preventative efficacy and warrants further investigation.
  • Long-term diet adherence was not negatively impacted by stone formation.

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