Ketogenic Diet for Polycystic Kidney Disease

The ketogenic diet proved to be effective at controlling polycystic kidney disease (PKD) in the first randomized controlled clinical trial of ketogenic metabolic therapy for PKD.

The researchers’ study is published in the journal Cell Reports Medicine.

For PKD patients, these findings represent an opportunity to control a genetic disease that leads to a progressive condition, causing pain and robbing them of their quality of life, and often resulting in the need for dialysis and kidney transplantation as the cysts destroy the kidneys’ ability to effectively filter and remove waste from the body.

This prevailing belief was what the Weimbs Lab and colleagues from various research institutions in Germany set out to challenge with their trial. Sixty-six PKD patients were recruited by the German research team headed by research physician Dr. Roman Müller of the University of Cologne and randomly split into three groups: a control group that received routine PKD counseling, another group that underwent a three-day water fast every month and a third group that observed a low-carbohydrate, high-fat ketogenic diet. The patients were followed closely with blood draws and MRI scans.

At the end of the three-month trial period, the researchers found that while the control group experienced the expected growth in the size of their kidneys, the ketogenic diet patients’ kidneys stopped growing and appeared to show a tendency to shrink somewhat, though the researchers pointed out that the shrinkage over the 90-day trial period failed to meet statistical significance.

The most striking evidence came in the form of measurably improved kidney function in the ketogenic diet patients which was statistically significant.

Kidney function was measured by the concentration of a protein called cystatin C — higher-than-normal concentrations of this protein in the blood indicate a faltering filtration system, a symptom that worsened in the control group.

There is no one ketogenic diet to fit all, however, according to Weimbs. To get the best out of their diet, PKD patients should consult with their physicians and nutritionists as they shift away from the usual carbohydrate and sugar-laden standard diets that are pervasive in industrialized societies.

These results represent a significant milestone for the Weimbs Lab, which has for more than two decades been researching the cell mechanisms that underlie PKD and other renal diseases. A chance discovery made by researchers in the lab — kidney cysts had dramatically shrunk in mouse models that had undergone caloric restriction — led them to pursue the idea that the fasting response known as ketosis might have some impact on the growth of the apparently glucose-dependent cysts.

With these results, Weimbs and his team are looking ahead to further clinical trials slated to start in the coming year, one in Toronto and the other in Tokyo, to assess the efficacy of a medical food they developed specifically to assist PKD patients in reaching ketosis. 

Sources:

Sadrija Cukoski, Christoph Heinrich Lindemann, Sita Arjune, Polina Todorova, Theresa Brecht, Adrian Kühn, Simon Oehm, Sebastian Strubl, Ingrid Becker, Ulrike Kämmerer, Jacob Alexander Torres, Franziska Meyer, Thomas Schömig, Nils Große Hokamp, Florian Siedek, Ingo Gottschalk, Thomas Benzing, Johannes Schmidt, Philipp Antczak, Thomas Weimbs, Franziska Grundmann, Roman-Ulrich Müller. Feasibility and impact of ketogenic dietary interventions in polycystic kidney disease: KETO-ADPKD—a randomized controlled trial. Cell Reports Medicine, 2023; 4 (11): 101283 DOI: 10.1016/j.xcrm.2023.101283

University of California – Santa Barbara. (2023, December 11). Clinical trial demonstrates that the ketogenic diet is effective at controlling polycystic kidney disease. ScienceDaily. Retrieved December 11, 2023 from www.sciencedaily.com/releases/2023/12/231211200118.htm
Image from: https://unsplash.com/photos/kidney-scale-model-in-hand-sRXCFkJahGk