Ketogenic diet: Outpatient initiation, without fluid, or caloric restrictions

Vaisleib, Inna; Buchhalter, Jeffrey; Zupanc, Mary L.

doi:10.1016/j.pediatrneurol.2004.03.007

Cited by 63 publications

(39 citation statements)

References 10 publications

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“…In a retrospective review of 54 patients undergoing initiation of the KD, 37 were initiated as outpatients and 17 as inpatients [39]. Furthermore, the majority of these patients did not undergo an initial fast.…”

Section: Initiation Of Diet and The Role Of Fastingmentioning

confidence: 99%

State of the ketogenic diet(s) in epilepsy

Huffman¹,

Kossoff

2006

Curr Neurol Neurosci Rep

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Fasting has been recognized as a treatment for seizures since ancient times. The ketogenic diet is a low-carbohydrate, adequate-protein, high-fat diet that biochemically mimics the fasting state and has been used to successfully treat seizures for 85 years. The diet has enjoyed a resurgence in popularity over the past decade and is gaining acceptance and use worldwide. Many studies over the past several years have explored possible mechanisms of action for the ketogenic diet. This review addresses these studies, as well as recent research regarding possible indications for the diet, variations in its initiation, side effect profiles, and the recent use of modified formulations to improve tolerability.

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Section: Initiation Of Diet and The Role Of Fastingmentioning

confidence: 99%

State of the ketogenic diet(s) in epilepsy

Huffman¹,

Kossoff

2006

Curr Neurol Neurosci Rep

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“…Volume restriction or depletion during acute illness heightens the risk of urolithiasis by concentrating the urine and its stone-forming solutes. Within the past decade, renal calculi have been reported in 1.4—8.7% of children on the KD (Freeman et al, 1998; Hassan et al, 1999; Furth et al, 2000; Maydell et al, 2001; Nordli et al, 2001; Kossoff et al, 2002a,b; Vaisleib et al, 2004; Sampath et al, 2007) and hematuria in as many as 10% (Lyczkowski et al, 2005). In general, lower rates are reported when GU imaging is restricted to patients with pain or macroscopic hematuria, whereas higher rates of urolithiasis are detected when imaging is also performed in cases of occult hematuria or hypercalciuric hypocitraturia.…”

Section: Introductionmentioning

confidence: 99%

Urolithiasis on the ketogenic diet with concurrent topiramate or zonisamide therapy

et al. 2010

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SummaryChildren with refractory epilepsy who are co-treated with the ketogenic diet (KD) and carbonic anhydrase inhibitor (CA-I) anti-epileptic medications including topiramate (TPM) and zonisamide (ZNS) are at risk for urolithiasis. Retrospective chart review of all children treated with ketogenic therapy at our institution was performed in order to estimate the minimal risk of developing signs or symptoms of stone disease. Children (N = 93) were classified into groups according to KD +/− CA-I co-therapy. Fourteen patients had occult hematuria or worse, including 6 with radiologically confirmed stones. Three of 6 calculi developed in the KD + ZNS group of 17 patients who were co-treated for a cumulative total of 97 months (3.1 stones per 100 patient months). One confirmed stone was in the KD + TPM group of 22 children who were co-treated for a cumulative total of 263 months (0.4 stones per 100 patient months). All six patients had at least three of five biochemical risk factors including metabolic acidosis, concentrated urine, acid urine, hypercalciuria and hypocitraturia. Standard of care interventions to minimize hypercalciuria, crystalluria and stone formation used routinely by pediatric nephrologists should also be prescribed by neurologists treating patients with combination anti-epileptic therapy. Non-fasting KD initiation, fluid liberalization, potassium citrate prophylaxis as well as regular laboratory surveillance are indicated in this high risk population.

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“…Los estudios no encuentran diferencias significativas entre las dos modalidades en cuanto al control de las convulsiones, 13,14 pero evitar la internación sin realizar ayuno podría reducir el estrés para el niño. Además, reduce el riesgo de hipoglucemia y deshidratación, el número de análisis de laboratorio y los costos.…”

Section: Inicio A) Con Internación O Ambulatoriamenteunclassified