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

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. <b>Methods:</b> A systematic literature search w...

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Main Authors: Prakrati Acharya, 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, Wisit Cheungpasitporn
Format: Article
Language:English
Published: MDPI AG 2021-05-01
Series:Diseases
Subjects:
Online Access:https://www.mdpi.com/2079-9721/9/2/39
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spelling doaj-8c271220f54a4feba417ae8e686ff4002021-06-01T01:00:43ZengMDPI AGDiseases2079-97212021-05-019393910.3390/diseases9020039Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-AnalysisPrakrati Acharya0Chirag Acharya1Charat Thongprayoon2Panupong Hansrivijit3Swetha R. Kanduri4Karthik Kovvuru5Juan Medaura6Pradeep Vaitla7Desiree F. Garcia Anton8Poemlarp Mekraksakit9Pattharawin Pattharanitima10Tarun Bathini11Wisit Cheungpasitporn12Division of Nephrology, Texas Tech Health Sciences Center El Paso, El Paso, TX 79905, USALea County Correctional Facility, Hobbs, NM 88240, USADepartment of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USADepartment of Internal Medicine, UPMC Pinnacle, Harrisburg, PA 17105, USADepartment of Medicine, Ochsner Medical Center, New Orleans, LA 70121, USADepartment of Medicine, Ochsner Medical Center, New Orleans, LA 70121, USADivision of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADivision of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADivision of Nephrology, Department of Internal Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USADepartment of Internal Medicine, Texas Tech University Health Science Center, Lubbock, TX 79430, USADepartment of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani 10120, ThailandDepartment of Internal Medicine, University of Arizona, Tucson, AZ 85721, USADepartment of Medicine, Mayo Clinic, Division of Nephrology and Hypertension, Rochester, MN 55905, USAVery-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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.https://www.mdpi.com/2079-9721/9/2/39ketogenic dietkidney stonesnephrolithiasisepidemiologymeta-analysissystematic review
collection DOAJ
language English
format Article
sources DOAJ
author Prakrati Acharya
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
Wisit Cheungpasitporn
spellingShingle Prakrati Acharya
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
Wisit Cheungpasitporn
Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
Diseases
ketogenic diet
kidney stones
nephrolithiasis
epidemiology
meta-analysis
systematic review
author_facet Prakrati Acharya
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
Wisit Cheungpasitporn
author_sort Prakrati Acharya
title Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
title_short Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
title_full Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
title_fullStr Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
title_full_unstemmed Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis
title_sort incidence and characteristics of kidney stones in patients on ketogenic diet: a systematic review and meta-analysis
publisher MDPI AG
series Diseases
issn 2079-9721
publishDate 2021-05-01
description 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.
topic ketogenic diet
kidney stones
nephrolithiasis
epidemiology
meta-analysis
systematic review
url https://www.mdpi.com/2079-9721/9/2/39
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