Will Low Carb High Fat Diet Increase Blood Urea Levels and Cause Kidney Failure

இந்த கட்டுரையின் தமிழ் வடிவம் குறைமாவு நிறைகொழுப்பு உணவு சாப்பிட்டால் யூரியா கூடி சிறுநீரகம் பாதிப்பு ஏற்படுமா ? என்ற பக்கத்தில் உள்ளது



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• Those who undergo Blood Investigations after few weeks of Low Carbohydrate High Fat diet are alarmed at increased in Blood Urea Levels as compared to previous test results.
• Those who are aware that Blood Urea Level Increases in Kidney Failure immediately get terrified and start to doubt whether their diet has affected the kidneys

Of course, when there is Renal Failure (i.e. Kidneys do not function properly), The Urea Level in Blood Increases
But
Renal Failure is not the only cause of Increase in Blood Urea Levels

Let us discuss this issue in detail in this article

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• Proteins in food  are broken down into Urea
• Urea has to be excreted
• Accumulation of Urea in Blood will affect Organs like Brain
• Urea is excreted by Kidneys

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The amount of Urea synthesised and the Amount of Urea Excreted are constant and hence urea level is maintained

Urea Level in Blood increases if

1. More Urea is Synthesised
2. Less Urea is Excreted

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• More Urea is Synthesised when More Proteins are taken
• Less Urea is Excreted when Kidneys do not function properly

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Urea Level in Blood increases if

1. More Proteins are Taken
2. Kidneys do not function properly

Urea in Blood is also increased in

1. Salt and Water Depletion
2. Vomiting
3. Diarrhea
4. Haemetemesis
5. Hemorrhage
6. Ulcerative Colitis
7. Addison’s disease
8. Acute Glomerulonephritis
9. Type II Nephritis
10. Malignant Nephrosclerosis
11. Pyelonephritis
12. Mercury Poisoning
13. Hydronephrosis
14. Renal Tuberculosis
15. Renal Calculi
16. Prostate enlargement
17. Tumours of Urinary Tract

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So

Kidneys are not affected by Low Carbohydrate High Fat Diet
But
When there is a pre existing Renal Failure (there is already kidney failure), the increased urea can affect organs like brain (uremic encephalopathy)

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Which Food Has More Chance of Affecting Kidney
A Food with hIgh carbs has more chance of affecting kidney

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Which Food has less chance of Affecting Kidney
A Low Carb High Fat Diet has Less Chance of Affecting Kidney

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To Put it in a nutshell,
Start Low Carbohydrate High Fat Diet or Paleo Diet and save your kidneys before they are damaged by High Carbohydrate Diet

Do you have evidence for this ?

Yes ! Please see

1. Comparative effects of low-carbohydrate high-protein versus low-fat diets on the kidney by Friedman AN, Ogden LG, Foster GD, Klein S, Stein R, Miller B, Hill JO, Brill C, Bailer B, Rosenbaum DR, Wyatt HRin Clin J Am Soc Nephrol. 2012 Jul;7(7):1103-11. doi: 10.2215/CJN.11741111. Epub 2012 May 31. who conclude that In healthy obese individuals, a low-carbohydrate high-protein weight-loss diet over 2 years was not associated with noticeably harmful effects on GFR, albuminuria, or fluid and electrolyte balance compared with a low-fat diet. Further follow-up is needed to determine even longer-term effects on kidney function.
2. A low-carbohydrate diet may prevent end-stage renal failure in type 2 diabetes. A case report by Jørgen Vesti Nielsen,  Per Westerlund, and Per Bygren in Nutr Metab (Lond). 2006; 3: 23. Published online 2006 Jun 14. doi: 10.1186/1743-7075-3-23 PMCID: PMC1523335 state that An obese patient with type 2 diabetes whose diet was changed from the recommended high-carbohydrate, low-fat type to a low-carbohydrate diet showed a significant reduction in bodyweight, improved glycemic control and a reversal of a six year long decline of renal function. The reversal of the renal function was likely caused by both improved glycemic control and elimination of the patient’s obesity. Insulin treatment in type 2 diabetes patients usually leads to weight increase which may cause further injury to the kidney. Although other unknown metabolic mechanisms cannot be excluded, it is likely that the obesity caused by the combination of high-carbohydrate diet and insulin in this case contributed to the patient’s deteriorating kidney function. In such patients, where control of bodyweight and hyperglycemia is vital, a trial with a low-carbohydrate diet may be appropriate to avoid the risk of adding obesity-associated renal failure to already failing kidneys.
3. Reversal of Diabetic Nephropathy by a Ketogenic Diet by Michal M. Poplawski, Jason W. Mastaitis, Fumiko Isoda, Fabrizio Grosjean, Feng Zheng, Charles V. Mobbs Published on April 20, 2011 in http://dx.doi.org/10.1371/journal.pone.0018604 conclude Intensive insulin therapy and protein restriction delay the development of nephropathy in a variety of conditions, but few interventions are known to reverse nephropathy. Having recently observed that the ketone 3-beta-hydroxybutyric acid (3-OHB) reduces molecular responses to glucose, we hypothesized that a ketogenic diet, which produces prolonged elevation of 3-OHB, may reverse pathological processes caused by diabetes. To address this hypothesis, we assessed if prolonged maintenance on a ketogenic diet would reverse nephropathy produced by diabetes. In mouse models for both Type 1 (Akita) and Type 2 (db/db) diabetes, diabetic nephropathy (as indicated by albuminuria) was allowed to develop, then half the mice were switched to a ketogenic diet. After 8 weeks on the diet, mice were sacrificed to assess gene expression and histology. Diabetic nephropathy, as indicated by albumin/creatinine ratios as well as expression of stress-induced genes, was completely reversed by 2 months maintenance on a ketogenic diet. However, histological evidence of nephropathy was only partly reversed. These studies demonstrate that diabetic nephropathy can be reversed by a relatively simple dietary intervention. Whether reduced glucose metabolism mediates the protective effects of the ketogenic diet remains to be determined.

Feel Free to ask doubts

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Acknowledgements

1. Dr.Arunkumar M.B., B.S., M.D., (Paediatrics) KMCH Erode for Journals