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What Do Ketones Do To Your Kidneys?

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What is rapidly progressive glomerulonephritis (RPGN; crescentic glomerulonephritis)? RPGN's a syndrome of the kidney that's characterized by proliferation of epithelial cells that form a crescent shape, and these changes can ultimately lead to acute renal failure. Find more videos at http://osms.it/more. Study better with Osmosis Prime. Retain more of what youre learning, gain a deeper understanding of key concepts, and feel more prepared for your courses and exams. Sign up for a free trial at http://osms.it/more. Subscribe to our Youtube channel at http://osms.it/subscribe. Get early access to our upcoming video releases, practice questions, giveaways and more when you follow us on social: Facebook: http://osms.it/facebook Twitter: http://osms.it/twitter Instagram: http://osms.it/instagram Osmosis's Vision: Empowering the worlds caregivers with the best learning experience possible.

Glomerulonephritis

Glomerulonephritis is the name given to a range of conditions that can affect the kidney, specifically the glomeruli of the kidney. The glomeruli become damaged, commonly because of a problem with the body's immune system. Many people with glomerulonephritis may not notice any symptoms initially. However, salt and excess fluid can build up in the body if the glomeruli and kidneys are not working normally. This can lead to complications such as high blood pressure and, in some cases, chronic kidney disease, which may lead to end-stage kidney disease. Treatment will depend on the underlying cause as well as the severity of symptoms. Understanding the kidneys and urine production The kidneys clear waste materials from the body and maintain a normal balance of fluids and chemicals in the body. The two kidneys lie to the sides of the upper tummy (abdomen), behind the intestines and on either side of the spine. The kidneys are higher up in the body than people imagine - from behind they are actually partially protected by the lowest ribs. The kidneys move slightly with a change in body position and with movement of the diaphragm with breathing. The diaphragm is the muscle under your lung Continue reading >>

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  1. SoxGirl02

    Its been a interesting 1.5 weeks. Last Last Frday 3/27, I thought I might have a kidney stone. I am prone to stones, so I know the sympoms etc. Friday it bothered me, Saturday it bothered me, Monday it bothered me. I went to the Urologist on this past Friday 4/3. He said there were large blood cells in my urine blah blah and I was to get a CT scan on Monday (yesterday). I get this call yesterday morning from the nurse in his office stating that I need to start Cipro immediatly becuase I deffinatly have a bladder infection, and a slight kidney infection (slight? its either infected or not infected!).
    I was exhausted yesterday, had the CT scan, came home and just crashed. 8pm woke up ate..something in my brain had me check the ketones about 9:30 last night. LARGE ketones. I start freaking because ive never had large ones....I call the doc on call and she tells me not to worry about it, its dehydration keep drinking and check in 2 hours. 2 hours it was fine.
    Today..they are back again! Am I over reacting to think that the 2 are related?

  2. gsmama

    Ketones and infection, yes!
    Are these urine ketones or blood ketones?
    Yes, you can get them from dehydration too. Very possible.
    Leslie

  3. andrea

    I agree that these can definately be related... hope you feel better soon.

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The Physiology Of The Urinary System

Last newsletter, we examined the anatomy of the urinary system. Today, we're going to examine the urinary system's functions -- focusing almost entirely on how your kidneys (and more specifically, the kidneys' nephrons) actually filter and balance your blood. Understanding how this works, and how you can prevent and reverse damage to the process and even assist it, is fundamental to maintaining optimum health. We'll conclude by exploring what your doctor learns about you when examining the results of your urinalysis. Wouldn't it be nice to actually know what your doctor is talking about when she makes recommendations to you based on the results of your test? Quick review of the anatomy of the urinary system As we discussed previously, water, waste, and in fact virtually everything other than red and white blood cells are pulled out of the blood in the balled mass of arterioles known as the glomerulus, located at the front end of the nephron. All of this "waste" material then passes into the renal tubule portion of the nephron for "fine tuning." Keep in mind, that at this point, what we're referring to as waste contains virtually everything including the kitchen sink. If your body c Continue reading >>

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  1. Deranged_hypnotist

    Hey all, So I began this Keto diet over 1 month ago and the results have been FANTASTIC! I have lost 35 pounds! (M/6'1 Sw: 245 CW: 210 GW: 180) I have been extremely happy with myself now and its all thanks to you guys. Sadly though yesterday while checking my ketosticks i saw blood in my urine and after a 7 hour ER visit I was told by the doctor that I had passed a kidney stone and gotten a UTI from it as well. I have never had a kidney stone in my life or any major health problems (aside from being overweight). The doctor told me to get off my diet until I can see an urologist to find out why I have a kidney stone. The thing is the next available appointment is not for a long time since I work 2 jobs. So I have done a bit of research and a side effect of being in ketosis is kidney stones (from random online website).
    So my questions to r/keto is 1. How often does this happen? 2. Is this Research Valid Online? 3. Where do I go from here?
    I still want to continue keto for the next 30 more pounds.
    P.S. I do not want this post to discourage anyone from trying keto, EVERYONE'S body is different.

  2. gogge

    Higher protein intake increases the calcium absorption in the gut, and consequently increases the calcium excreted in the urine. Ketosis increases the need to balance blood pH as ketones are acidifying, one way the body likely does this i by increasing calcium leaching from the bones, this also increases urine calcium excretion.
    Increased calcium levels in the urine increases the risk of calcium-oxalate stone formation.
    Excretion of ketones in the urine increases urine acidity, as does the increased excretion of uric acid (can lead to supersaturation, the uric acid can't dissolve and form crystals).
    Increased urine acidity increases the risk of kidney stone formation, lower levels of citrate in the urine also increases the risk of stone formation.
    Paul over at perfecthealthdiet.com has an article on kidney stones and carb restriction, "Dangers of Zero-Carb Diets, IV: Kidney Stones".
    Generally the best way to counter this is to eat more vegetables, most have a negative potential renal acid load (PRAL), which means they'll reduce the acidity of urine (here's a list of foods and their PRAL score). Even calcium rich foods can help as the calcium will bind to oxalate (chelation) in the gut and prevent absoption.
    Increased water intake also helps as it balances the urine pH and prevents supersaturation (through dilution) as you pee more, in general dehydration is a common risk factor for stone formation.
    Another more drastic way to reduce calcium excretion, reduce urine acidity, and increase urine excretion of citrates, is to supplement with potassium citrate. It's been tested in epilepsy studies and resulted in a very high reduction in stone formation incidents (0.9% of patients compared to the 25% Paul mentions in his article):
    Successful empiric administration of Polycitra K at KD onset resulted in a kidney-stone incidence of 0.9% (1 of 106) compared with administration only because of hypercalciuria, 6.7% (13 of 195; P = .02).
    McNally MA, et al. "Empiric use of potassium citrate reduces kidney-stone incidence with the ketogenic diet." Pediatrics. 2009 Aug;124(2):e300-4. Epub 2009 Jul 13.
    You probably need to talk to your doctor about that as potassium is usually limited to ~99 mg for OTC tablets.
    Anecdotaly another thing sometimes used is sodium (or potassium) bicarbonate, as it also reduces urine acidity. I haven't seen any studies on it, but WebMD has some articles on it, "Sodium Bicarbonate (Baking Soda) for Kidney Stones". It's probably a good idea to discuss this with your doctor before starting taking any.

  3. [deleted]

    I had kidney stones about 3 years ago and from what I understand is that there are two different types. Calcium stones and uric acid stones.
    Calcium stones are more often than not a result of not enough fluid intake or an over abundance of calcium in your diet. Were talking multiple Tums a day, a wheel of cheese, gallons of cream - for most people. Others can just be an increase in calcium intake that the body is not used to. Such as going from little to no calcium intake, to hitting well over the suggested daily amount. This could very well be the case with you.
    From what I understand as well, uric acid stones are likely hereditary.
    At the end of the day, no, your keto diet is not the cause of your Kidney stones.
    Personally, I would never wish the pain of a kidney stone onto my worst enemy. So your best course of action is to be sure you're drinking plenty of water. Make sure your pee is always crystal clear. Increase your magnesium intake, either via supplements or more easily, eat an avocado every day. You also have to make sure you supplement your magnesium with calcium. This sounds counterintuitive to what I just stated, but the two work in conjunction with each other ( i dont know the exact science of it). I would suggest chewing on 1 or 2 Tums a day (depending on how much cheese and other dairy products you're already eating).
    Hope this helps!

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Moof's Medical Biochemistry Video Course: http://moof-university.thinkific.com/... In this video, I describe how Ketone Bodies are oxidized for energy. The liver makes ketone bodies that travel through the blood to extrahepatic tissues, where they are oxidized in the mitochondrial matrix to give energy. The pathway begins with D--Hydroxybutyrate, as it is oxidized to Acetoacetate by the same D--Hydroxybutyrate Dehydrogenase reaction (except in reverse). The Acetoacetate is then activated to Acetoacetyl-CoA by -Ketoacyl-CoA Transferase (also known as Thiophorase); this second step takes a Coenzyme A from Succinyl-CoA (an intermediate of the Krebs Cycle). The Acetoacetyl-CoA is then cleaved into two Acetyl-CoA molecules that can go through the Krebs Cycle to be oxidized, resulting in energy that cell can use. Ultimately, the liver is basically sending Acetyl-CoA that it isnt metabolizing to other tissues (by way of Ketone Bodies in the blood) so that those other tissues can utilize the Acetyl-CoA. However, sometimes, the extrahepatic tissues do not oxidize the ketone bodies rapidly enough to keep up with the pace at which they are arriving from the blood. This is a problem described

The Role Of The Kidney In The Removal Of Ketone Bodies Under Different Acid-base Status Of The Rat.

Abstract Arterial blood concentrations of ketone bodies, pyruvate, lactate, citrate, and oxoglutarate were measured in normal and in nephrectomized rats. The rate of removal from the circulation of an infused acetoacetate load has been studied in both groups of animals. Blood oxoglutarate and ketone bodies remained unchanged in nephrectomized rats. Blood citrate level rose rapidly. In rats with normal blood pH the contribution of the kidneys to the removal of ketone bodies is 28%, whereas in metabolic alkalosis, it is less than 2%. In nephrectomized rats with normal blood pH and in rats with metabolic alkalosis the ratio between beta-hydroxybutyrate and acetoacetate is very high in comparison with rats having metabolic acidosis. These data suggest that in metabolic alkalosis the kidneys are not able to utilize ketone bodies. Continue reading >>

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  1. driven1

    OK.... I'm a keto newbie, on Day 9 of the 12 day start up. As and aside, I feel great and am loving the food choices.
    ANYWAY... I have a girl friend who is an RN (and a very good one), who has cautioned me that ketones are 'hard on the kidneys'.
    Now, I love my GF to death, and I know that she means only the best, but I have very little confidence in the conventional medical community. After all, this is an industry that makes it's money from people being sick...
    My research has turned up that ketones are NOT damaging to the kidneys. On the contrary, the kidney uses ketones as a preferred fuel source when they can get them. The heart and brain as well as other major organs prefer them too...
    Seems as though the confusion is with the fact that a lot of medical professionals consider the excessive protein while on a keto diet damaging to the kidneys. I have also found research that dispels this... showing that only individuals who already have compromised kidney functions MIGHT have a problem with excess protein in the diet.
    I'm looking for comments from those who are experienced with the keto lifestyle. What do you know??

  2. titebuoy

    excessive dietary protein causes your kidneys to work harder to remove excess nitrogen. however, the keto is a high fat diet, not a high protein diet so i wouldnt be worried about it unless your macros are out of wack. some people have trouble with foamy urine on the diet, but most people dont experience kidney trouble on keto.

  3. stew9812

    I'm new to this too.
    I think what they teach the doctors/nurses is whats best for the general public. (people that don't work out, and don't necessarily get enough water ect..) So they may not always have the best answers for people like us.
    I would say to just drink plenty of water, and you will be fine.
    Just my opinion here, but like you say there is plenty of people who have done this diet with no bad side effects, and there is plenty of research supporting this to be a healthy diet as well.
    just my .02

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