Impressive weight loss induced by a very low-calorie ketogenic diet in a morbidly complex obese patient with a recent episode of acute kidney injury and advanced chronic kidney disease: a case report

Submitted: 10 August 2024
Accepted: 29 August 2024
Published: 25 September 2024
Abstract Views: 131
PDF: 79
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

The very low-calorie ketogenic diet (VLCKD), characterized by a marked energy restriction that induces rapid weight loss, has recently been proposed as a valid nutritional strategy for managing obesity. VLCKD is commonly considered dangerous for the kidneys due to the misconception that it is high in protein, beyond the risk of electrolyte imbalances and an increase in diuresis. We report a case of safe and effective weight loss induced by VLCKD in a 43-year-old Caucasian woman with a recent episode of acute kidney injury on advanced chronic kidney disease. Surprisingly, we observed that after the diet-induced weight loss, not only did renal function not worsen, but proteinuria also improved. The principal value of this case report is its singular demonstration of impressive weight loss induced by VLCKD in a complex obese patient that was apparently not accompanied by the development of serious adverse sequelae.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

PlumX Metrics

PlumX Metrics  provide insights into the ways people interact with individual pieces of research output (articles, conference proceedings, book chapters, and many more) in the online environment. Examples include, when research is mentioned in the news or is tweeted about. Collectively known as PlumX Metrics, these metrics are divided into five categories to help make sense of the huge amounts of data involved and to enable analysis by comparing like with like.

Citations

Barrea L, Caprio M, Camajani E, et al. Ketogenic nutritional therapy (KeNuT)-a multi-step dietary model with meal replacements for the management of obesity and its related metabolic disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-diet therapies in endocrinology and metabolism. J Endocrinol Invest 2024;47:487-500. DOI: https://doi.org/10.1007/s40618-023-02258-2
Verde L, Lucà S, Cernea S, et al. The fat kidney. Curr Obes Rep 2023;12:86-98. DOI: https://doi.org/10.1007/s13679-023-00500-9
Joshi S, Kalantar-Zadeh K, Chauveau P, et al. Risks and benefits of different dietary patterns in CKD. Am J Kidney Dis 2023;81:352-60. DOI: https://doi.org/10.1053/j.ajkd.2022.08.013
Bruci A, Tuccinardi D, Tozzi R, et al. Very low-calorie ketogenic diet: a safe and effective tool for weight loss in patients with obesity and mild kidney failure. Nutrients 2020;12:333. DOI: https://doi.org/10.3390/nu12020333
Joshi S, Shi R, Patel J. Risks of the ketogenic diet in CKD – the con part. Clin Kidney J 2023;17:sfad274. DOI: https://doi.org/10.1093/ckj/sfad274
Brinkworth GD, Buckley JD, Noakes M, et al. Renal function following long-term weight loss in individuals with abdominal obesity on a very-low-carbohydrate diet vs high-carbohydrate diet. J Am Diet Assoc 2010;110:633-8. DOI: https://doi.org/10.1016/j.jada.2009.12.016
Zainordin NA, Warman NAE, Mohamad AF, et al. Safety and efficacy of very low carbohydrate diet in patients with diabetic kidney disease-A randomized controlled trial. PLoS One 2021;16:e0258507. DOI: https://doi.org/10.1371/journal.pone.0258507
Kalantar-Zadeh K, Fouque D. Nutritional management of chronic kidney disease. N Engl J Med 2017;377:1765-76. DOI: https://doi.org/10.1056/NEJMra1700312
Yan B, Su X, Xu B, et al. Effect of diet protein restriction on progression of chronic kidney disease: a systematic review and meta-analysis. PLoS One 2018;13:e0206134. DOI: https://doi.org/10.1371/journal.pone.0206134
Watanabe M, Tuccinardi D, Ernesti I, et al. Scientific evidence underlying contraindications to the ketogenic diet: an update. Obes Rev 2020;21:e13053. DOI: https://doi.org/10.1111/obr.13053
Puchalska P, Crawford PA. Multi-dimensional roles of ketone bodies in fuel metabolism, signaling, and therapeutics. Cell Metab 2017;25:262-84. DOI: https://doi.org/10.1016/j.cmet.2016.12.022
Gutiérrez-Repiso C, Hernández-Garcıa C, García-Almeida JM, et al. Effect of synbiotic supplementation in a very-low-calorie ketogenic diet on weight loss achievement and gut microbiota: a randomized controlled pilot study. Mol Nutr Food Res 2019;63:e1900167. DOI: https://doi.org/10.1002/mnfr.201900167
Simeoni M, Citraro ML, Cerantonio A, et al. An open-label, randomized, placebo-controlled study on the effectiveness of a novel probiotics administration protocol (ProbiotiCKD) in patients with mild renal insufficiency (stage 3a of CKD). Eur J Nutr 2019;58:2145-56. Erratum in: Eur J Nutr 2018;58:2157. DOI: https://doi.org/10.1007/s00394-018-1785-z
Parra Guasca M, Manafi M, Parnham A, Angus R. Use of a very low calorie diet for weight loss in a patient with acute kidney injury and class III obesity: a case study. J Ren Nutr 2023;33:698-702. DOI: https://doi.org/10.1053/j.jrn.2023.05.005
Frank H, Graf J, Amann-Gassner U, et al. Effect of short-term high-protein compared with normal-protein diets on renal hemodynamics and associated variables in healthy young men. Am J Clin Nutr 2009;90:1509-16. Erratum in: Am J Clin Nutr 2010;91:494. DOI: https://doi.org/10.3945/ajcn.2009.27601

How to Cite

Trapanese, V., Pelle, M. C., Capria, M., Carullo, N., Vatalaro, C., Cosentino, F., Melina, M., Natale, M. R., Giofrè, F., & Arturi, F. (2024). Impressive weight loss induced by a very low-calorie ketogenic diet in a morbidly complex obese patient with a recent episode of acute kidney injury and advanced chronic kidney disease: a case report. Italian Journal of Medicine, 18(3). https://doi.org/10.4081/itjm.2024.1787