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Ketogenic Diet May Help Treat Polycystic Kidney Disease

by Dr. Trupti Shirole on November 11, 2023 at 12:33 PM
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Highlights:

A clinical investigation on special diets at the University of Cologne found promising findings in the use of a ketogenic diet as a potential treatment for hereditary polycystic kidney disease (ADPKD) (1).

What is Polycystic Kidney Disease?

Polycystic kidney disease is the most common genetic kidney disease in the world, accounting for around 10% of all cases of renal failure.


Ketogenic Diet as a Therapy for Polycystic Kidney Disease

Professor Dr. Roman-Ulrich M�ller and his team at the University Hospital Cologne and the University of Cologne's Aging Research Excellence Cluster CECAD undertook the Keto-ADPKD investigation. Professor M�ller's translational nephrology team at CECAD focuses on dietary therapies that improve longevity and illness prevention. One of these dietary regimes, the ketogenic diet, was studied as a therapy for polycystic kidney disease in the KETO-ADPKD research. The article 'Feasibility and impact of ketogenic dietary therapy in polycystic kidney disease: KETO-ADPKD - a randomized controlled trial' has now been published as a cover story in the prestigious magazine 'Cell Reports Medicine'.

Ketogenic Diet Can Improve Kidney Function

M�ller presented the study's topline findings at the American Society of Nephrology's 'Kidney Week' in November 2022. The phase II-like study's final results, which are now public, also demonstrate that switching to a ketogenic diet can improve kidney function in ADPKD patients. The study included 66 patients who were divided into three groups: one that followed a ketogenic diet for three months, another that did three days of water fasting once a month - a kind of zero diet that only allows drinking water - and a third that followed standard dietary recommendations.

Skip Bread and Sweets to Improve Renal Function

One of the most notable findings was that 95% of patients in the ketogenic group and 85% in the water-fasting group thought the diet was doable. Many critics were first skeptical: it would be impossible to change one's diet in ordinary life. However, the participants held a different opinion. Furthermore, the researchers were able to employ biomarkers - ketone bodies - assessed in blood samples to indicate that the subjects had followed the diet as instructed. Unlike many other food studies, the design of this one is similar to that of a typical pharmacological trial (randomized controlled), and so fulfills the highest criteria.

‘A ketogenic diet shows promise in transforming the treatment landscape for hereditary polycystic kidney disease. #kidneyhealth’

The ketogenic diet appears weird at first look since it eliminates carbs such as sugar or bread while consuming more fat. This diet has also been researched in terms of its overall life-prolonging effect. According to research group leader M�ller, it appears that it can be adopted by patients in everyday life, which is an important finding in KETO-ADPKD. "You have to skip bread and sweets, and, for example, you use more olive oil - fatty fish such as salmon are also a great food in this regard."

The study was able to show the following: Positive changes in critical indicators such as renal function were observed after only three months, with no unanticipated adverse effects. The positive changes in kidney function were statistically significant and exceeded the researchers' expectations, which included Professor M�ller, a professor of translational nephrology, and his team at CECAD of the University of Cologne and the University Hospital Cologne - which included Franziska Grundmann as co-senior author and head of the Clinical Study Centre (Dept. II of Internal Medicine), Sadrija Cukoski and Christoph Lindemann as joint first authors, and Thomas Weimbs and his team at the University of California, Santa Barbara.

Dietary Intervention for Polycystic Kidney Disease

Professor Dr. Roman-Ulrich M�ller believes that the study's findings are an essential step toward the development of a potential new treatment for polycystic kidney disease. However, he emphasizes that these findings from a phase II-like design research are insufficient to advocate the ketogenic diet for all individuals with polycystic kidney disease. Larger studies at other sites are needed to confirm the findings and determine whether long-term improvements in kidney function can be achieved without side effects.

In general, however, the current study is already quite significant since, through its design in the manner of a drug trial, it demonstrates that food can be as effective as medicine. M�ller believes "this could be the starting point for many dietary treatment strategies."

Reference:
  1. When nutrition becomes therapy: little sugar and a lot of fat against cystic kidneys - (https:portal.uni-koeln.de/universitaet/aktuell/presseinformationen/detail/wenn-ernaehrung-zur-therapie-wird-wenig-zucker-und-viel-fett-gegen-zystennieren)
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