Can Keto Diet Cause Kidney stones
Is the keto diet not good for your kidneys, especially considering the incidence and characteristics of kidney stones in individuals with type 1 diabetes?
The keto diet craze has swept the country—and it is no surprise, given its popularity among those seeking rapid weight loss, including individuals with epilepsy.
You can—and will—get there on the high-fat, low-carbohydrate ketogenic diet that has so many of us falling in love with it and that can help all sorts of other conditions too—the type of traditional “brain fog” we all get while studying for a test.
But as with any diet, including low-carb diets, there are risks, and kidney stones can be one of them.
In this post, we are going to cover keto, kidney stones, and the effects of ketogenic diets as well as the systematic review and meta-analysis on their relationship.
We’ll also provide tips on how to prevent kidney stones in patients following a keto diet.
What are kidney stones, and how do they relate to low-carbohydrate, high-protein diets?
Kidney stones are so common—with about 1 in 10 or so people being affected by them—that you’d think there’d be more agreement on how best to give advice for them, right?
They are most frequently seen in adults between 30 and 60 years of age, but the incidence may vary for people with type 2 diabetes.
The condition is most commonly related to having too much calcium or oxalate in the urine, both of which can cause kidney stones. The size of stones varies from a grain of sand to a golf ball.
With plenty of fluids and pain medicine, most kidney stones will be pushed out of the body in the urine, especially if citrate levels are maintained.
But certain stones, such as uric acid stones, can get stuck in the urinary tract, causing a painful blockage. If so, you may need painkillers and treatment to remove the stone.
Should you have kidney stones, your doctor or dietitian may discuss with you an eating plan, potentially including elements of the Mediterranean diet, to reduce the formation of new stones.
For instance, it could also mean that you ought to cut back on some high-calcium or high-oxalate foods to improve your bone health, especially if you follow a plant-based diet.
You will also need to drink additional liquids to prevent dehydration and reduce the risk factors associated with kidney stones, especially on a version of the ketogenic diet, which is a restrictive diet.
What causes kidney stones?
The possible causes of kidney stones are countless, with some being related to metabolic disorders.
Most kidney stones develop when the urine is too concentrated, leading to mineral crystals accumulating and sticking together, which can be exacerbated in individuals with type 1 diabetes.
You can be dehydrated, your diet could have caused it (super high in animal protein and salt), or there could be a possible problem that is interfering with kidney function, increasing the risk of kidney stones in patients.
Being dehydrated is among the most common causes of kidney stones. When an individual is dehydrated, urine will become more concentrated, allowing minerals to form crystals.
Animal protein or salt, Yin in our diet, can result in high amounts of urine, calcium, and other things that can cause kidney stone formation, particularly uric acid stones.
Some medical conditions—including kidney disease, gout,and bowel surgery—and use of some calcium-based antacids can change the type of urine you produce in a way that encourages the formation of stones.
How the keto diet may cause kidney stones
The keto diet has even been associated with an increase in the formation of kidney stones due to higher levels of dietary fat and lower carbohydrates (1).
That’s actually because it induced the body to produce more acid, which in turn can get deposited as kidney stones, affecting the characteristics of kidney stones and potentially leading to chronic kidney disease (2).
What are some of the other dangers of the keto diet, particularly in relation to kidney stones and chronic kidney disease?
Sure, there are other health issues associated with keto, including an increased risk of kidney stones and cardiovascular disease, which is a concern for people with type 2 diabetes.
These include dietary fat, ketone levels, and hydration strategies to mitigate the risk of kidney stones.
Hypoglycemia may occur in individuals with type 2 diabetes on a ketogenic diet, which can also affect the incidence of kidney stones. It lowers insulin and can cause blood sugar to drop, particularly in individuals with type 1 diabetes.
It can make you dizzy, tremble, sweat profusely, and get confused.
If you have diabetes or have to take medication to control your blood sugar, you will just need to be even more cautious with the keto diet, as it can also affect your uric acid levels.
Dehydration: The keto diet can actually cause you to become dehydrated, as it robs your body of some of the most fiber-rich and water-containing foods that exist—tons of different fruits and vegetables.
Signs of dehydration are grumpiness, concentrated urine, thirst, and lethargy, which can increase the risk factors for kidney stones.
Kidney stones can be influenced by dietary choices, including those made in low-carbohydrate, high-protein diets. Okay, hear me out regarding the increased risk of kidney stones. What I'm going to say is bad, but not that bad for the majority of you, but you can experience an increase in kidney stones by a 5-10% risk of forming kidney stones due to you pissing out more calcium while on the diet, also, the risk is apparently much worse for men.
Gout: Gout is a form of arthritis that can cause a very painful, hot, red joint, and it may be influenced by metabolic changes in the body, particularly with calcium and uric acid levels.
How can I avoid kidney stones while on the keto diet?
Some potentially prostate-friendly things to add to your keto diet that might help keep the incidence and characteristics of kidney stones at bay include citrate-rich foods.
Drink plenty of water. And it’ll water down your urine, so it’s less likely to form stones, which is crucial for those on a low-carb diet.
I like Bing Better — Changing Personal Eating Habits of Animal Protein. More animal protein can also boost the risk of kidney stones. Choose plant-based proteins instead.
Avoid processed or sugar-laden food to help maintain bone health while on a low-carbohydrate diet. These can promote kidney stone formation, particularly in individuals on a version of the ketogenic diet (3).
Get enough magnesium. This mineral might also prevent kidney stones by stopping calcium from crystallizing in the urine and forming a stone.
Final Thoughts
In all honesty, there really isn’t a one-size-fits-all answer to this question, as how your body takes to the keto diet can look vastly different from one person to the next, especially concerning uric acid levels.
And there is data to suggest that the keto diet may, in fact, cause kidney stones in some people due to the increased production of ketones and elevated calcium and uric acid levels. If you’re interested in trying the keto diet, consult your doctor first to see if it’s safe for you.
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FAQs on Keto Diet and Kidney Stones
Does the keto diet damage your kidneys?
Not necessarily, although the keto diet raises acid levels in the body, which can elevate the risk of kidney stones in some people. Drinking enough water and consulting with your doctor can help reduce the risk of kidney stones in patients.
Why would the keto diet cause kidney stones, especially in individuals with pre-existing high uric acid levels?
The keto diet alters how your body processes acid and calcium, sometimes resulting in the formation of stones, especially when the body adjusts to ketosis. Greater excretion of calcium and uric acid in the urine are both important.
Is a keto diet also safe for people who have had kidney stones in patients on ketogenic diets?
Yes, but you’ll have to be more careful about the risk of low blood sugar. Flushing the system with juices and water, moderating animal protein so you don’t build up uric acid, and balancing electrolytes to reduce stone risk and get through keto flu—all good conventional advice if you want to stay in ketosis and follow a conventional diet that’s grain/potato/bean free.
How do I avoid kidney stones on keto?
Drink enough water, cut back on salt and processed foods, and consider switching to more plant-based proteins, while making sure you get enough magnesium and potassium to maintain mineral balance.
Are there other keto side effects I should be concerned about, such as the impact on bone health or increased heart disease risk?
Some individuals develop “keto flu,” dehydration, and gout, particularly early on. These are all short-term effects of ketogenic diets and something that can be mitigated by a well-planned diet including whole grains.
Related Studies
1. Title: Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis (2021)
Pooled data from 36 studies (n=2,795) found an overall kidney-stone incidence of ~5.9% in people on ketogenic diets (≈5.8% children; 7.9% adults), with uric-acid stones most common.
Link: https://europepmc.org/article/PMC/PMC8161846
2. Title: Nephrolithiasis Associated with the Ketogenic Diet (J Urol, 2000)
Case series in children on the ketogenic diet identified metabolic drivers of stones—including metabolic acidosis, hypercalciuria, and hypocitraturia—clarifying the mechanistic link between KD and stone formation.
Link: https://europepmc.org/article/MED/10893623
3. Title: Empiric Use of Potassium Citrate Reduces Kidney-Stone Incidence with the Ketogenic Diet (Pediatrics, 2009)
In children starting the ketogenic diet, potassium citrate prophylaxis significantly lowered stone incidence (from ~10.5% to ~2.0%), supporting citrate for prevention.
Link: https://publications.aap.org/pediatrics/article/124/2/e300/72343/Empiric-Use-of-Potassium-Citrate-Reduces-Kidney
