Abstract: SA-PO0579
Between a Rock and a Hard Diet: Transformation of Stone Type After Ketogenic Diet
Session Information
- Bones, Stones, and Mineral Metabolism: Research and Cases
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Palad, Maria Karina, Lenox Hill Hospital, New York, New York, United States
- Linden, Ellena A., Lenox Hill Hospital, New York, New York, United States
- Patel, Anuj A., Lenox Hill Hospital, New York, New York, United States
Introduction
Recurrent nephrolithiasis is a condition influenced by many factors including dietary habits. Stone composition conversion occurs in about 33% of recurrent stone formers. Ketogenic diets, which have gained popularity for weight loss, are associated with increased risk of nephrolithiasis through mechanisms such as acid load, hypocitraturia, and low urinary pH that favor uric acid stone formation. We present a case of a stone type conversion to uric acid in a patient with recurrent calcium oxalate stones after a switch to ketogenic diet.
Case Description
A 69-year-old man with history of benign prostatic hyperplasia, and osteoarthritis was referred for evaluation of recurrent nephrolithiasis. He has no family history of kidney disease or nephrolithiasis. He began passing kidney stones at the age of 40. He reports having passed many stones, the composition of which was 70-90% calcium oxalate, 10-30% uric acid. Patient then adopted a strict ketogenic diet for weight loss. Approximately 1.5 years after changing his diet, the patient again developed recurrent stone episodes. Repeat stone analysis demonstrated a transition to predominantly uric acid nephrolithiasis (80-100% uric acid, 0-20% calcium oxalate).
Discussion
This case highlights the effect of dietary modification on kidney stone composition. It also underscores the importance of repeat stone analysis and repeat comprehensive metabolic evaluation in patients with recurrent nephrolithiasis Early recognition of diet-associated metabolic risk factors is critical in preventing recurrent stones and progressive kidney injury.