Ketogenic diet may reverse diabetic nephropathy

A specialized diet high in fat and low in carbohydrates, known as the ketogenic diet, may reverse impaired kidney function in diabetes, according to researchers from the Mount Sinai School of Medicine.

“Our study is the first to show that a dietary intervention alone is enough to reverse this serious complication of diabetes,” Charles Mobbs, PhD, professor of neuroscience and geriatrics and palliative care medicine at Mount Sinai School of Medicine, said in a press release. “This finding has significant implications for the tens of thousands of Americans diagnosed with diabetic kidney failure, and possibly other complications, each year.”

The researchers evaluated mice genetically predisposed to have type 1 or type 2 diabetes. Half of the mice were put on the ketogenic diet and a control group maintained a standard, high-carbohydrate diet. After 8 weeks, molecular and functional indicators of kidney damage were reversed in the mice on the ketogenic diet, according to the results. In addition, kidney pathology in the model of type 2 diabetes was partially reversed on microscopic analysis, according to a press release.

They also identified a previously unreported panel of genes associated with diabetes-related kidney damage, whose changes in expression were reversed by the diet.

A ketogenic diet is typically used to control seizures in children with epilepsy. It is low in carbohydrates, moderate in protein and high in fat. Since high glucose metabolism is thought to cause kidney failure in diabetes, researchers hypothesized that the ketogenic diet would hinder the toxic effects of glucose. The diet is not a long-term solution in adults due to the extreme requirements. However, Mobbs’ research indicates that exposure to the diet for a limited period may be enough to “reset” the gene expression and pathological process leading to kidney failure, according to the press release.

The researchers will continue to research the effect of the ketogenic diet and the mechanism by which it may reverse kidney failure in people with diabetes, as well as age-related kidney failure.

“Knowing how the ketogenic diet reverses nephropathy will help us identify a drug target and subsequent pharmacological interventions that mimic the effect of the diet,” Mobbs said in the release. “We look forward to studying this promising development further.”

The findings were published online in PLoS ONE. The study was funded partly by the NIH and the Juvenile Diabetes Research Foundation.

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