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Abstract: PO0414

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

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Acharya, Prakrati C., Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
  • Medaura, Juan Antonio, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Acharya, Chirag, LCCF, Hobbs, New Mexico, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
Background

Very-low-carbohydrate diets or ketogenic diets have frequently been 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 2,795 patients on ketogenic diets were enrolled. The estimated pooled incidence of kidney stones was 5.6% (95%CI, 4.4%-7.1%) in patients on ketogenic diets at mean follow-up time 3.7+/- 2.9 years. Subgroup analyses demonstrated the estimated pooled incidence of kidney stones of 5.6% (95%CI, 4.3%-7.2%) in children and 5.6% (95%CI, 2.3%-12.6%) 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.

Conclusion


The estimated incidence of kidney stones in patients on ketogenic diets is 5.6%. Its incidence is comparable among adults and children. 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.