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Ketogenic Diet vs. Kidneys | Keto’s Effect on the Kidneys | Kidneys Stones Explained- Thomas DeLauer

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Ketogenic Diet vs. Kidneys | Keto’s Effect on the Kidneys | Kidneys Stones Explained- Thomas DeLauer…
Keto & Gene Expression:
A study published in the journal Kidney International looked at nephropathy (term used when the kidneys start to incur damage, which can ultimately lead to kidney failure) in diabetic mice (3)
The researchers found the genes responsible for nephropathy (nephrin, ZO-1 and podocin) were reversed – this helped restore the mice’s kidneys back to healthy functioning. Specifically, the study found that keto increased the expression of SIRT1, which led to a reduction in the genes responsible for nephropathy. In indications of energy surplus, such as glycogen and insulin, inhibit activation of AMPK – ketosis decreases these factors that inhibit AMPK. Through a very long process ketosis is able to activate SIRT1 indirectly through activation of AMPK.
https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2781128

SIRT1:
SIRT1 is a protein or vehicle that requires NAD+ to function – SIRT1 takes acetyl groups off of proteins. SIRT enzymes “turn off” certain genes that promote aging, such as those involved in inflammation, in fat synthesis and storage, and in blood sugar management. When proteins are undergoing stress, acetyl groups are added to proteins as a response to changes induced by inflammation and oxidation. Sirtuins (like SIRT1) remove these acetyl groups to keep the protein in service longer than usual, while simultaneously stabilizing the charge state of the carbon backbone in protein to resist any further changes in their shape. This allows your cellular proteins to live longer and you can save energy on other processes.

Keto & Glomerular Lesions:
Glomerular filtration rate (GFR) is a test to measure how well the kidneys filter blood and remove waste. Glomeruli, the small units within the kidney where blood is filtered – they act as tiny filters within the kidneys and each kidney contains millions of glomeruli. If the glomeruli become damaged, the kidney can no longer remove waste and excess fluids efficiently – blood and protein cannot be filtered and are excreted in the urine. Too much glucose may cause glomerular lesions in patients with poor glucose control, leading to impairment of the kidneys. Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units – glomerulonephritis refers to a range of inflammatory kidney conditions of the tiny blood vessels in the kidneys. High glucose levels are thought to make the blood flow into the kidney at a higher speed, putting a strain on the filtering process and raising blood pressure. The capillaries in the glomerulus collapse and can leave the glomeruli with scarring.

Meta Analysis – British Journal of Nutrition:
The review measured the impact of low carb diet on renal function taking into account 1000 people from nine randomised controlled trials found that:

“a low carbohydrate diet and the corresponding high-protein diet was not harmful for renal function in overweight and obese individuals without renal dysfunction.”

Furthermore, it concluded that a low carb diet may even improve renal function thanks to its weight loss effects.

References:
1) Impact of low-carbohydrate diet on renal function: a meta-analysis of over 1000 individuals from nine randomised controlled trials. (2016, August 28). Retrieved from https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/impact-of-lowcarbohydrate-diet-on-renal-function-a-metaanalysis-of-over-1000-individuals-from-nine-randomised-controlled-trials/0EAA25E700C06D2C5125F0AB195FB33F

2) University of Wisconsin Hospitals and Clinics Authority. (2010, June 24). How Do Kidney Stones Form? Retrieved from https://www.uwhealth.org/urology/how-do-kidney-stones-form/11210

3) Nesbitt, H. (n.d.). Kidney Week. Retrieved from https://www.asn-online.org/education/kidneyweek/2017/program-abstract.aspx?controlId=2781128

4) Hong Q , et al. (n.d.). Increased podocyte Sirtuin-1 function attenuates diabetic kidney injury. – PubMed – NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29477240

5) Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health. (2018, February 11). Retrieved from https://www.hindawi.com/journals/jnme/2018/5157645/

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