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Article

Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis

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Division of Nephrology, Texas Tech Health Sciences Center El Paso, El Paso, TX 79905, USA
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Lea County Correctional Facility, Hobbs, NM 88240, USA
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Department of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USA
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Department of Internal Medicine, UPMC Pinnacle, Harrisburg, PA 17105, USA
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Department of Medicine, Ochsner Medical Center, New Orleans, LA 70121, USA
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Division of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
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Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock, TX 79430, USA
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Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 10120, Thailand
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Department of Internal Medicine, University of Arizona, Tucson, AZ 85721, USA
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Authors to whom correspondence should be addressed.
Academic Editor: Ilse Daehn
Diseases 2021, 9(2), 39; https://doi.org/10.3390/diseases9020039
Received: 24 April 2021 / Revised: 20 May 2021 / Accepted: 21 May 2021 / Published: 25 May 2021
Very-low-carbohydrate diets or ketogenic diets are frequently used for weight loss in adults and as a therapy for epilepsy in children. The incidence and characteristics of kidney stones in patients on ketogenic diets are not well studied. Methods: A systematic literature search was performed, using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the databases’ inception through April 2020. Observational studies or clinical trials that provide data on the incidence and/or types of kidney stones in patients on ketogenic diets were included. We applied a random-effects model to estimate the incidence of kidney stones. Results: A total of 36 studies with 2795 patients on ketogenic diets were enrolled. The estimated pooled incidence of kidney stones was 5.9% (95% CI, 4.6–7.6%, I2 = 47%) in patients on ketogenic diets at a mean follow-up time of 3.7 +/− 2.9 years. Subgroup analyses demonstrated the estimated pooled incidence of kidney stones of 5.8% (95% CI, 4.4–7.5%, I2 = 49%) in children and 7.9% (95% CI, 2.8–20.1%, I2 = 29%) in adults, respectively. Within reported studies, 48.7% (95% CI, 33.2–64.6%) of kidney stones were uric stones, 36.5% (95% CI, 10.6–73.6%) were calcium-based (CaOx/CaP) stones, and 27.8% (95% CI, 12.1–51.9%) were mixed uric acid and calcium-based stones, respectively. Conclusions: The estimated incidence of kidney stones in patients on ketogenic diets is 5.9%. Its incidence is approximately 5.8% in children and 7.9% in adults. Uric acid stones are the most prevalent kidney stones in patients on ketogenic diets followed by calcium-based stones. These findings may impact the prevention and clinical management of kidney stones in patients on ketogenic diets. View Full-Text
Keywords: ketogenic diet; kidney stones; nephrolithiasis; epidemiology; meta-analysis; systematic review ketogenic diet; kidney stones; nephrolithiasis; epidemiology; meta-analysis; systematic review
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MDPI and ACS Style

Acharya, P.; Acharya, C.; Thongprayoon, C.; Hansrivijit, P.; Kanduri, S.R.; Kovvuru, K.; Medaura, J.; Vaitla, P.; Garcia Anton, D.F.; Mekraksakit, P.; Pattharanitima, P.; Bathini, T.; Cheungpasitporn, W. Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis. Diseases 2021, 9, 39. https://doi.org/10.3390/diseases9020039

AMA Style

Acharya P, Acharya C, Thongprayoon C, Hansrivijit P, Kanduri SR, Kovvuru K, Medaura J, Vaitla P, Garcia Anton DF, Mekraksakit P, Pattharanitima P, Bathini T, Cheungpasitporn W. Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis. Diseases. 2021; 9(2):39. https://doi.org/10.3390/diseases9020039

Chicago/Turabian Style

Acharya, Prakrati, Chirag Acharya, Charat Thongprayoon, Panupong Hansrivijit, Swetha R. Kanduri, Karthik Kovvuru, Juan Medaura, Pradeep Vaitla, Desiree F. Garcia Anton, Poemlarp Mekraksakit, Pattharawin Pattharanitima, Tarun Bathini, and Wisit Cheungpasitporn. 2021. "Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis" Diseases 9, no. 2: 39. https://doi.org/10.3390/diseases9020039

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