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Keto and Your Kidneys: The Bizarre Truth

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Keto and Your Kidneys: The Bizarre Truth – Thomas DeLauer

Keto & Gene Expression

A study published in the journal Kidney International looked at nephropathy (term used when the kidneys start to incur damage, which can ultimately lead to kidney failure) in diabetic mice (3)

The researchers found the genes responsible for nephropathy (nephrin, ZO-1 and podocin) were reversed – this helped restore the mice’s kidneys back to healthy functioning

Specifically, the study found that keto increased the expression of SIRT1, which led to a reduction in the genes responsible for nephropathy

In indications of energy surplus, such as glycogen and insulin, inhibit activation of AMPK – ketosis decreases these factors that inhibit AMPK

Through a very long process ketosis is able to activate SIRT1 indirectly through activation of AMPK


SIRT1 is a protein or vehicle that requires NAD+ to function – SIRT1 takes acetyl groups off of proteins

SIRT enzymes “turn off” certain genes that promote aging, such as those involved in inflammation, in fat synthesis and storage, and in blood sugar management
When proteins are undergoing stress, acetyl groups are added to proteins as a response to changes induced by inflammation and oxidation.
Sirtuins (like SIRT1) remove these acetyl groups to keep the protein in service longer than usual, while simultaneously stabilizing the charge state of the carbon backbone in protein to resist any further changes in their shape

This allows your cellular proteins to live longer and you can save energy on other processes

Keto & Glomerular Lesions

Glomerular filtration rate (GFR) is a test to measure how well the kidneys filter blood and remove waste

Glomeruli, the small units within the kidney where blood is filtered – they act as tiny filters within the kidneys and each kidney contains millions of glomeruli

If the glomeruli become damaged, the kidney can no longer remove waste and excess fluids efficiently – blood and protein cannot be filtered and are excreted in the urine

Too much glucose may cause glomerular lesions in patients with poor glucose control, leading to impairment of the kidneys

Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units – glomerulonephritis refers to a range of inflammatory kidney conditions of the tiny blood vessels in the kidneys

High glucose levels are thought to make the blood flow into the kidney at a higher speed, putting a strain on the filtering process and raising blood pressure

The capillaries in the glomerulus collapse and can leave the glomeruli with scarring

Meta Analysis – British Journal of Nutrition

The review measured the impact of low carb diet on renal function taking into account 1000 people from nine randomised controlled trials found that:

“a low carbohydrate diet and the corresponding high-protein diet was not harmful for renal function in overweight and obese individuals without renal dysfunction.”

Furthermore, it concluded that a low carb diet may even improve renal function thanks to its weight loss effects


1) Impact of low-carbohydrate diet on renal function: a meta-analysis of over 1000 individuals from nine randomised controlled trials. (2016, August 28). Retrieved from

2) University of Wisconsin Hospitals and Clinics Authority. (2010, June 24). How Do Kidney Stones Form? Retrieved from

3) Nesbitt, H. (n.d.). Kidney Week. Retrieved from

4) Hong Q , et al. (n.d.). Increased podocyte Sirtuin-1 function attenuates diabetic kidney injury. – PubMed – NCBI. Retrieved from

5) Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health. (2018, February 11). Retrieved from

29 thoughts on “Keto and Your Kidneys: The Bizarre Truth

  1. but thomas, what about polycystic kidney disease? its a genetic disease which pretty much makes your kidneys shut down and you get put on dialysis and replaced kidneys and all sorts and its genetic and theres nothing you can do about it as far as im concerned. my dad has it and is going on dialysis soon and my grandmother has it and she had a kidney replaced and her mother also had it and so on and im due to have a DNA test to see if i have it soon (im 18) and i keep trying to tell my dad how keto or any low carb diet is good for the kidneys but he wont believe me, im getting a doctors appointment soon to get a reference to the specialist that will do the DNA test for me and i was also going to talk about keto (i already know this doctor is pro keto from other local keto'ers) just to get proof from a doctor that keto is good because my parents dont believe me even though i lost 1/4 of my body weight (was 91kg, now 68kg and 7.3% body fat and was 26% or so, i was very overweight at a young age due to what i was fed and after losing more fat will work on body building) and ive never been healthier, but its really hard going day to day with the crap i go through from them and if i do have polycystic kidney disease it could majorly prove a point, not that i care so much about proving the point but i was wandering if it would be any different for a genetic disease opposed to decaying kidneys from a bad diet. cheers though thomas, i owe so much to you for helping me lose weight and become fitter then ever. and come to australia some time (specifically adelaide)

  2. Thomas great video but I do have a question. I have been on Keto for 5 months and seen amazing results. My girlfriend wants to be supportive and help keep me on the path, but she only has one kidney. Would she be at any risks for issues with her kidney due to the Keto diet?

  3. Thank you for this explanation. I help my 83yr old mothet manage her diabetes. One health care provider scared me into thinking the keto diet could harm her kidneys. He also advised her to drink a gallon of water a day. Honestly, you really have to research this stuff for yourself. Such conflicting information!

  4. The whole time I'm watching you, I keep thinking, "Why does this guy look familiar?" IT JUST HIT ME!!!!!! You resemble "The Hollywood Medium" Tyler Henry! Man, that was bugging me. 🙂

  5. Thomas, you did it again!
    I was just looking about kidney stones and Keto and you once again guessed and made a video about it!
    I'm on Keto for more than a year, and since January I have been struggling with a 6mm kidney stone that have decided take it's way out, and guess what?
    Today morning it finally get out.
    I still have one in same kidney that have 13mm and I have to go through a ureteroscopy to break that stone with laser.

  6. I hope you read your comments because you helped me through 2 months ok Keto where I lost 40lbs. I came off Keto for a month now, where I’ve included normal eating, fast food for lunch, slushies with the kids and I haven’t gained any wait. Good? I don’t know. Keto changed me in some way.

  7. I had kidney stones twice just from poor diet and dehydration… However now that I'm following your advice and been on a keto diet now for about two months, my blood pressure is back to normal, I've lost 20lbs and my kidneys feel great. Now I have the energy to go to the gym again and build some good muscle without feeling like total trash.

  8. I got a kidney stone about 3 months after staring keto, but it was because of the high oxalate foods I had been eating, but didn't know about this whole issue. Once I found out what the cause was, and researched it, I cut down on the oxalates and starting drinking lemon water, and taking both potassium and magnesium citrates, which help counteract oxalates. No problems since, and that was 3 years ago.

  9. I have been doing Keto for about year. Did my blood work recently and my Doctor was amazed with my blood work. Especially my kidney function.

  10. Mr delauer, please help, I am on keto for long time, 6 moths had gout, which was very sever and reoccurring almost every other week. After 4 months i had no more attacks of gout. Now i am 53 old, in a very good shape and weight and have tons of energy, i workout 6 days a week 2hrs high intensity and bodybuilding. All my blood readings are good but the uric acid which is very very high. I am concern about this although i am not suffering from kidney stones or gout. Do you have any explanation and advise.

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