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Kidney pain on keto: Everything You Need to Know

Everything You Need to Know

​Are you getting frustrated with that sharp lower back pain you’ve been dealing with?

  • What causes kidney pain on a Keto Diet?
  • What does kidney pain on Keto Diet feel like?
  • What to do about kidney pain on Keto Diet?
  • And a whole lot more!

A number of the ketogenic community may suffer from sharp lower back pain and be completely perplexed of the underlying cause.

Read Also: The Ketogenic Diet: Ultimate guide for beginners

However, this issue only occurs during ketoacidosis, a complication that results from dangerously high levels of ketones and blood sugar (most frequently seen in those with diabetes), not ketosis.

The belief is that metabolites and by-products of animal protein digestion and metabolism may increase urinary acidity and contribute to kidney stone formation.

Read Also: The Best Keto Meters for Weight Loss: Know your Ketone levels

A 2016 meta-analysis investigating the impacts of low-carbohydrate diet on renal (kidney) function ultimately 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”.

Read Also: The Best Keto Books to Grow Your Knowledge While Cutting Carbs

  • Blood clots in the kidney – The most common cause of this clot is typically from another condition known as Nephrotic Syndrome. Nephrotic Syndrome is a condition in which large amounts of protein are lost in the urine, and blood flow then gets an increased tendency to form clots within the kidneys.
  • Blunt force trauma to the lower back – Kidneys are located just in front of your lower back, and are very sensitive. If you get hit at the right angle, fall or suffer any other form of impact to that area, you can cause some serious damage to the structure of your kidneys (and may lead to you urinating blood in more extreme instances of trauma).
  • Urinary Tract Infection (UTI) – A U.T.I leads and can cause fairly severe pain all the way up to the kidney along the urinary tract.
  • Kidney infection – A kidney infection takes place when bacteria from an associated infection of the bladder has started to spread to the kidneys. Kidney infections cause a great degree of inflammation which in turn can contribute to the pain sensation, particular across the lower back.

Kidney pain can be hard to pinpoint and distinguish from pain of the lower back.

  • Fever
  • Painful urination
  • Cloudy or bloody urine
  • Dizziness
  • Constipation
  • A persistent need to urinate
  • Flank pain
  • Nausea
  • Vomiting
      • Muscular pain
      • Muscular or Spine Injury
      • Joint Pain
      • Nerve Pain
      • Arthritis

​If you’re experiencing severe pain in the lower left flank, we’d again have to advise you go see a medical professional. Always better to be safe than sorry!

It has long been known that vegetarian diets appear to have a protective effect against kidney stone disease with prevalence of kidney related issues being almost half that of those with an atypical western diet.

A vegetarian diet also has a high alkalinizing power on urines, leading to a higher urine pH, resulting in a lower risk for uric acid stones.

Read Also: Learn about the various diet options with a meal delivery service like Freshly

      • Full-fat tofu
      • Tempeh
      • Nuts and Seeds
      • Nut and seed butters
      • Vegan high protein cheese (e. g. cashew cheese)
      • Egg whites


Chronic dehydration is a risk factor for kidney stones. Many in the keto community suffer from dehydration unawares.

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  • Now Supplements, Potassium Gluconate 99 mg

Read Also: The Best Keto Fiber Supplements for Optimal Health in 2020

Home » Nutrition » Keto » Kidney Pain and Keto: Everything You Need to Know

Is the Keto Diet Bad for Your Kidneys?

The relationship between keto and kidneys is complicated. While keto has been around for a while, there is still a lack of research on the long term effects of the diet.


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In this article, you are going to learn whether keto is bad for your kidneys, what happens to your kidneys during ketosis, and if keto can cause kidney stones.

Is Keto Bad for Your Kidneys?

There is no straight answer to whether keto is bad for your kidneys. However, it is generally considered safe for you if your kidneys are in good health. On the other hand, if you have any kidney complications or fully developed kidney disease, you shouldn’t follow the ketogenic diet without consulting your nephrologist.

In general, if your kidneys are functioning normally, you may even experience some health benefits from following a ketogenic diet. These include improved blood sugar control, cardiovascular function, and weight loss (* , *).

A study on 68 obese individuals found no decline in renal function after one year on a very low carbohydrate diet (*). Another meta-analysis on 1000 individuals actually found an improvement in renal function in participants that were on low-carbohydrate diets (*). While these studies possess certain weaknesses, they seem to indicate that there is no direct link between keto and kidney disease.

What Happens to My Kidneys During Ketosis?

You should expect changes in your kidney function on keto due to the increased levels of ketones in your urine.

The first change you can expect to see is due to the negative charge ketones bear. Since ketones are negatively charged, they may result in increased excretion of positively charged ions such as potassium in the urine. This is simply because the negative charge will attract the positive charge during the process of urine filtration (*).

The other change often wrongfully associated with ketosis is increased acidity of urine. This comes from the confusion between ketoacidosis and ketosis.

Ketosis is a natural metabolic state that occurs when the body burns fat for fuel instead of carbohydrates, such as on a ketogenic diet. It is a completely normal physiological response to low blood glucose levels, and it can also occur under certain conditions such as prolonged exercise or pregnancy. In this state, the body produces ketones that can be used for energy in place of glucose. Ketosis is generally considered safe and even beneficial for weight loss and improved insulin sensitivity.

On the other hand, ketoacidosis is a serious medical condition that occurs when the body produces too many ketones, leading to an imbalance in blood pH. This usually occurs in people with uncontrolled diabetes, particularly type 1 diabetes, where insulin levels are low and the body cannot use glucose properly.

Due to the acidic nature of ketones, ketoacidosis has an impact on urine pH due to the high concentration of ketones. Severe ketoacidosis is a life-threatening condition that can lead to coma or death if left untreated.

Can Keto Cause Kidney Stones?

Kidney stones are lumps of minerals and salts found in the kidneys. If treated early, kidney stones often don’t result in any complications. However, if left to grow, they can cause intense pain and sometimes kidney disease.

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There is some speculation about whether keto can lead to kidney stones. Those who believe this to be true cite the high protein nature of the ketogenic diet as the reason why it increases kidney stone risk.

However, there are two flaws to this argument. First, keto isn’t a high protein diet but a high-fat diet. The ketogenic diet recommends a protein intake of about 1.2-2 grams per kilogram of body weight which is the same protein content of a typical diet. Furthermore, there is still debate about whether the increased consumption of animal protein is a risk factor for kidney stones. A study that followed 78,293 women for multiple years found that different nutritional factors influenced kidney stone risk but consumption of animal protein wasn’t one of them. The factors that had an impact on kidney stone risk were sodium consumption, calcium consumption, water intake, and body weight (*).

Secondly research currently shows a limited relationship between the ketogenic diet and increased risk of kidney stones. A study on 195 children following a ketogenic diet for five years found that only 6.7% of them developed kidney stones.

No child was taken off the diet due to the stones as there was no statistically significant relationship between kidney stone incidence and the ketogenic diet (*). However, there are a number of studies that suggest a stronger relationship between low-carb diets and kidney stones (*). It should, however, be noted that the majority of these studies were conducted on subjects following very strict versions of the ketogenic diet.

The studies above all found that supplementation with potassium citrate reduced the occurrence of kidney stones suggesting a relationship between mineral salts and kidney stones in people following keto. For this reason, anyone following a ketogenic diet should ensure to optimize electrolyte intake, particularly, positively charged electrolytes like potassium.

Fruits and vegetables are some of the best sources of electrolytes in the diet, however, a high quality electrolyte supplement can also be effective in boosting electrolyte levels in the blood. Electrolyte supplementation should be accompanied by adequate water intake to minimize stress on the kidneys.

In addition to boosting your electrolyte intake, you can also lower your risk for kidney stones by limiting oxalate-rich foods and high sodium foods. Some of the oxalate rich foods to watch out for includes spinach, beets, rhubarb, miso, and sweet potatoes.

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Should People At Risk for Kidney Disease Try Keto?

It is not recommended for people with or at risk of kidney disease to try keto without speaking to a qualified health professional.

With recommendation and supervision from your healthcare provider, a ketogenic diet can have a positive effect on kidney disease. In many cases, kidney disease is triggered by conditions such as type 2 diabetes, overweight, and heart disease, all of which have been shown to be positively impacted by following a low-carbohydrate diet (*).

In a case study of an obese man with renal disease triggered by type 2 diabetes, a low-carbohydrate diet resulted in reversal of six year long decline of renal function, weight loss, and improved glycemic control (*). While this study shows great promise in the use of low-carb diets for renal failure, better studies with more participants need to be conducted.

The limited research on the effects of different diets on kidney disease is due to the strict nature of dietary recommendations for patients with kidney disease. Currently, the best diet for an individual living with kidney disease should be personalized to their needs.

The Bottom Line

In conclusion, there appears to be little to no association between keto and kidney disease. In fact, those with healthy kidneys can expect to experience some health benefits such as improved blood sugar control and weight loss. While scientific evidence shows little proof of keto diet side effects on kidney health, individuals with kidney disease shouldn’t start a ketogenic diet without consulting their nephrologist.


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10 References

Noakes M et al. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women. 2005 June

Athinarayanan S et al. Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial. 2019 June 05

Athinarayanan S et al. Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial. 2019 June 05

Oyabu C et al. Impact of low-carbohydrate diet on renal function: a meta-analysis of over 1000 individuals from nine randomised controlled trials. 2016 June 27

Sigler M. The mechanism of the natriuresis of fasting. 1975 February 1

Sorensen M et al. Impact of Nutritional Factors on Incident Kidney Stone Formation: A Report From the WHI OS. 2012 March 14

Sampath A et al. Kidney stones and the ketogenic diet: risk factors and prevention. 2007 April

Acharya P et al. Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis. 2021 May 25

Nielsen J et al. A low-carbohydrate diet may prevent end-stage renal failure in type 2 diabetes. A case report. 2006 June 14

Nielsen J et al. A low-carbohydrate diet may prevent end-stage renal failure in type 2 diabetes. A case report. 2006 June 14

nutrition when kidneys or stones hurt

KetoDieta.su » Articles

The ketogenic diet benefits both healthy people and those with certain pathologies. One of the main reasons for its effectiveness is a calorie deficit, but there are other wonderful physiological aspects. The keto diet has become very popular for weight loss and sugar control. But can cutting out carbohydrates damage the kidneys or worsen pre-existing conditions?


  1. Misconceptions about the effect of the keto diet on the kidneys
  2. Kidney pain on the keto diet
  3. Keto diet and kidney stones
  4. How to avoid bad kidney effects on the keto diet

Misconceptions about the effects of keto – diets for the kidneys

Kidney diseases (nephroptosis, pyelonephritis and others) are relative contraindications for the ketogenic diet. Even with a long remission, a new diet can lead to a relapse. It is necessary to exclude carbohydrates from the diet, consult a nephrologist and take tests.

The kidneys produce urine, which passes into the bladder 24 hours a day. They constantly filter a large amount of blood and perform the following functions:

  1. Remove excess fluid.

  2. Achieving optimal balance of fluids, minerals and electrolytes.

  3. Regulation of blood pressure.

  4. Disposal of waste, toxins and drugs.

These organs also produce hormones that help maintain healthy blood and bones, including the production of calcitriol, the active form of vitamin D. In short, the kidneys are like the sanitation department of a big city. A person cannot survive without them, so you need to monitor your well-being and follow a healthy diet.

Many diseases, drugs, toxins and hereditary disorders can damage the kidneys. However, the two most common causes of problems with these organs are diabetes and high blood pressure, which can damage delicate blood vessels and tissues. If the root causes of these two diseases are not addressed, chronic disease and kidney failure can result.

In the case of diabetes, high blood sugar levels for a long time can cause glucose to bind to vital proteins in the bloodstream. This process, known as glycation, results in the formation of advanced glycation end products. They can cause abnormal changes in proteins and receptors that damage filter segments. This glycation creates a vicious cycle of additional tissue damage, leading to progressive kidney damage called diabetic nephropathy.

Other changes occur with high blood pressure. As a result of exposure to blood that moves too fast and with great force, scars occur that damage the kidneys. This leads to loss of their functions and to chronic disease or kidney failure.

The best way to prevent kidney damage and kidney failure is to treat and prevent diabetes and high blood pressure. Fortunately, there is some good news: these diseases can be significantly corrected on a ketogenic diet. In addition, this type of diet increases insulin resistance, so the body will gradually absorb carbohydrates better without glucose remaining in the blood.

Kidney pain on keto diet

Most of the side effects appear mostly at the beginning. Kidney pain on a ketogenic diet may be due to water-releasing fat cells.

To improve your well-being you need:

  1. Do not consume much protein.

  2. Control the amount of water you drink.

  3. Reduce salt intake.

  4. Strictly follow the diet.

  5. Refuse power loads, including exercise therapy.

Keto diet and kidney stones

It is often said that the keto diet and kidney stones are incompatible. On a low-carbohydrate diet, signs of hypercalcemia are observed, leading to the formation of stones. For prevention, potassium supplements should be taken (they are introduced into the diet anyway). But still, it should be noted that the effect of a ketogenic diet on stone formation is minimal.

How to avoid bad kidney consequences on a keto diet

Almost all side effects are an adaptive response. The ketogenic diet for kidney problems requires following a meal plan. It is important to monitor your condition, take tests and get advice from a doctor. Pain does not last more than 5 days.

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Mojo Academy VIDEO | Keto Diet Effects on Kidneys |KETO-MOJO

You see, all too often we hear only negative things. We hear people talking about how the ketogenic diet can give you kidney stones or the excess protein you eat on a ketogenic diet is bad for the kidneys in general. The point is that this is not entirely true, but there is a lot of positive scientific evidence that shows that the ketogenic diet is indeed very beneficial for helping the kidneys and supports the overall long life of kidney cells. I’m Thomas DeLauer with Keto-Mojo and we’ll talk about how the ketogenic diet really affects the kidneys.

The first thing I want to talk about is kidney stones. We usually think that kidney stones are just those composite crystals that form because we are either super dehydrated or because we have a poor diet. The reality is that it’s much more complicated, and in truth, kidney stones are actually more genetically formed than anything else. We are either genetically predisposed to kidney stones or not. Kidney stones are simply the formation of crystals that aggregate too much. In other words, we already have crystals in our urine. The crystals in our urine are simply components of various minerals, types of minerals that come together and eventually form either a small crystal or a larger crystal.

There are three factors we need to pay attention to when it comes to kidney crystal formation. It will be; Do we have many products to promote crystals? Don’t we have enough anti-crystal products? Or are we just super dehydrated or have a very low urine volume? These are the only three factors that come into play when it comes to developing larger kidney stones, and the ketogenic diet really has nothing to do with it. You see, as long as you’re getting minerals, if you’re eating a healthy diet in the first place, there’s no reason a ketogenic diet should lead to more kidney stones. This is purely a genetic thing and is really only caused by a serious problem with urinary obstruction or a very poor diet.

Now, when it comes to protein intake on a ketogenic diet and how it can damage the kidneys, frankly, it just doesn’t matter. Many of the studies that protein is bad for the kidneys have now been completely debunked. In fact, we often find that protein does help keep cells alive in the kidney. Also, when you’re on a ketogenic diet, you don’t eat a ton of protein, you actually eat less protein on a keto diet than you probably would on a regular diet. So really, not even a cause for concern there. But yes, let’s look at the positives, like the study published in Kidney International that the ketogenic diet actually supports the genetic function that allows kidney cells to live longer. In the study, they looked at what is called nephropathy, where the kidney starts to die. They found that when patients followed a low-carb ketogenic diet, they experienced an increase in what is called the SIRT1 gene. SIRT1 basically activates a defense mechanism that protects proteins in the kidney. In fact, our kidneys became stronger and more protected when we went on a ketogenic diet. This is all due to the activation of AMPK, when the body essentially starts to go into conservation mode because we are deprived of glucose. This is a very powerful thing.

Another topic we need to pay attention to is that when we are on a ketogenic diet, we have lower glucose levels, which means we have lower insulin levels, and this was assumed before higher glucose levels and higher insulin levels increase the amount of blood that rushes through the filtering portion of the kidneys. While this sounds like a good thing, when you really jam it in the filtration process, you can cause the little capillaries in the kidney to really break down and this will lead to scar tissue. Scar tissue can form lesions and can be very detrimental to your overall health, not to mention your kidney health, so a ketogenic diet actually reduces the risk of this.

Finally, let’s take a look at a meta-analysis that was published in the British Journal of Nutrition. When looking at 1,000 participants from several studies, a ketogenic or low-carbohydrate diet did not have any detrimental effect on kidney or kidney health or kidney function. It didn’t change anything. You may be concerned or at least think that it is a little easier to become dehydrated on a ketogenic diet, just make sure you drink water and you won’t get any kidney problems. The only thing we might be interested in, or at least know, is that when you go on a ketogenic diet, you lose some water and you’re usually a little dehydrated because more water is said to be excreted by the kidneys.