Ketones In The Urine Kidney Failure

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Clearing Up Kidney Confusion: Part Deux

It’s funny how our mental state really affects how we write and what we are interested in. When I wrote the introduction to this piece I was just getting settled into our new place in Santa Fe, NM and was looking at over a month at home to work and write. Then a number of wacky events happened and I’ve been home about 7 days out of the last month and I’ve only made it about 70 pages into Kon-Tiki. Ouch. Now I’m home for 8 days and will then be gone for a project that will take me completely off the grid for nearly 3 weeks. No phone, email…nada. When I sat down to do this kidney piece it was with a mindset that I had a ton of time and could really sink my teeth into it. Now I’m time crunched and anxious that I will get it done at all! Up front here I’d like to thank Mat “The Kraken” Lalonde with his help on some literature for this piece. Any inaccuracies however are my own tomfoolery. If I wanted to cut to the chase I could boil this whole thing down to the following: 1-Dietary protein DOES NOT CAUSE KIDNEY DAMAGE. 2-Chronically elevated BLOOD GLUCOSE levels DO cause kidney damage. 3-Dietary fructose REALLY causes kidney damage. 4-Many kidney issues have either a Continue reading >>

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Popular Questions

  1. Injecto

    I can't seem to find anything that backs this up. I know that high BG will damage them over time (duh!!), but what about ketones?

  2. fgummett

    Ketone bodies are water-soluble compounds that are produced as by-products when fatty acids are broken down for energy. They are a vital source of energy during fasting -- such as overnight.
    The brain gets its energy from ketone bodies when insufficient glucose is available. In the event of low blood glucose, most other tissues have additional energy sources besides ketone bodies (such as fatty acids), but the brain does not.
    Remember that when you are not fasting, the body can use Amino Acids (from dietary Protein) to synthesize Glucose (Gluconeogenesis).
    Any production of Ketones is called ketogenesis, and this is necessary in small amounts. When even larger amounts of ketone bodies accumulate such that the blood's pH is lowered to dangerously acidic levels, this state is called ketoacidosis. This happens in untreated Type I diabetes (DKA).
    In short, the human body has evolved over the millennia to burn either Glucose or Fatty Acids -- think of these as the short-term fuel and longer-term reserve, respectively.
    So if it is normal to burn Fatty Acids and produce Ketones why would they be harmful unless they accumulate to dangerous levels? Yes I know... we always get the "dangerous levels" lecture but consider that BG can be toxic at high enough levels... that does not mean it is bad for us at any level


    can we get the production of ketones correct??
    The primary cause of ketogenesis in the body is.....
    gluconeogenesis from dietary protein, when there is insufficient dietary glucose to fill the body needs, aka the ketogenic diet.
    The process of gluconeogenesis utilises a key component of the citric acid cycle (oxaloacetate), which blocks the oxidation of Acetyl CoA. Fatty acid (and glucose oxidation) require their conversion to Acetyl CoA. It is Acetyl CoA which is converted to ketone bodies and this process occurs pretty exclusively in the liver (also happens in the kidney)
    Normally oxidation of fatty acids does NOT produce ketone bodies, even during fasting overnight, as usually there are more than sufficient stores of glycogen.
    - starvation is an entirely different matter. Fasting for longer than a day or so can be sufficient for ketogenesis to start.
    Astrocytes in the brain can produce ketone bodies in response to hypoglycemia, but this will not provide adequate protection in the event of hypoglycemia caused by insulin overdose.
    The simple reason why ketogenesis as caused by a ketogenic diet is probably safe is because ketones only transiently rise in response to food, and the levels sustained should not be sufficient to disturb the body's buffer system.
    if however you spent long periods without food, or lacking insulin then that is a very different matter.
    I can't find anything definitive about ketones and kidney function - the only thing of note is an association with kidney stones for children on ketogenic diets to control epilepsy - but this could be due to the components of the diet (high protein) rather than ketones. There are no long term safety studies on ketogenic diets, but they are though to be safe (probably).
    Those on this forum on low carbohydrate diets 50g to 120g of carbs probably do not experience ketogenesis to any significant degree. Significant ketogenesis only occurs at <30g.

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