Renal Stone Associated with the Ketogenic Diet in a 5-Year Old Girl with Intractable Epilepsy

Abstract

In this paper, we report on a 5-year-old girl who developed a renal stone while following the ketogenic diet to treat refractory seizure disorder. Three months after initiating the ketogenic diet, she developed severe abdominal pain and vomiting. The spot urine calcium-to-creatinine (Ca/Cr) ratio and 24-hour urine evaluation showed hypercalciuria. Computed tomography (CT) imaging revealed a stone in the right ureteropelvic junction, resulting in hydronephrosis of the right kidney. The renal stone disappeared 5 days after conservative treatment; the patien's microscopic hematuria resolved concurrently. In light of this case report, we recommend regularly monitoring the urine Ca/Cr ratio with ultrasonography for further development of renal stones in patients following the ketogenic diet. If these patients exhibit evidence of symptomatic hypercalciuria or cyristalluria, liberalization of fluid restriction and urine alkalization using oral potassium citrate should be considered.

The ketogenic diet for Dravet syndrome and other epileptic encephalopathies: An Italian consensus

“…Gastrointestinal symptoms including vomiting, constipation, diarrhea, and abdominal pain occur in 12–50% of children on the KD (Kang et al., 2004); renal calculi occur in 3–7% (Furth et al., 2000; Kossoff et al., 2002; Sampath et al., 2007) making regular monitoring necessary (Choi et al., 2010). Potassium citrate supplementation is warranted to reduce the incidence of kidney stones (McNally et al., 2009).…”

Popular Diets: Ketogenic Diet

“…Furthermore, due to its high fat content, ketogenic diet is not recommended for people with certain liver conditions, pancreatic disease, thyroid problems, or gallbladder disease, or for people who have had their gallbladders removed (Gordon 2019). Reports have described kidney stones developing in children on a ketogenic diet (Choi et al 2010).…”

Dietas populares: Dieta cetogénica

“…Además, debido a su alto contenido de grasa, la dieta cetogénica no se recomienda para personas con ciertas afecciones hepáticas, enfermedad de la vesícula biliar o aquellas a las que se les extirpó la vesícula biliar, enfermedad pancreática y problemas de tiroides (Gordon 2019). Los informes han descrito el desarrollo de cálculos renales (piedra en el riñon) en niños con una dieta cetogénica (Choi et al 2010).…”