Are you getting frustrated with that sharp lower back pain you've been dealing with?
It's a good thing you're in the right place! In this guide, you'll learn:
- What causes kidney pain on a Keto Diet?
- What does kidney pain on Keto Diet feel like?
- What to do about kidney pain on Keto Diet?
- And a whole lot more!
A number of the ketogenic community may suffer from sharp lower back pain and be completely perplexed of the underlying cause.
The issue itself may not be related to your back at all, but instead your kidneys.
Whilst many will jump on the bandwagon to condemn the ketogenic diet and it’s possible contribution to kidney issues, we’re going to take an objective look - why people believe keto is the culprit, identify other possible causes for the aforementioned pain and strategies you can use to work towards improving the condition.
What Causes Kidney Pain on a Keto Diet?
There are two primary arguments against the ketogenic diet when it comes to kidney pain;
Ketones cause heightened stress on the kidneys due to increased urine activity
However, this issue only occurs during ketoacidosis, a complication that results from dangerously high levels of ketones and blood sugar (most frequently seen in those with diabetes), not ketosis.
The dangerously high levels of ketones and blood sugar makes blood too acidic and this is what causes the undue pressure and stress on kidney function and health.
The ketosis achieved following an atypical ketogenic diet will result in levels of blood ketones within a normal range; a perfectly safe level that will have no impact on kidney function.
A Ketogenic diet causes increased frequency of kidney stone formation
Kidney stones are hard deposits of minerals and salts that form in the urinary tract and can be incredibly painful.
Ketogenic diets have been associated with the development of kidney stones due to the fact many in the community have diets which are rich in animal proteins.
The belief is that metabolites and by-products of animal protein digestion and metabolism may increase urinary acidity and contribute to kidney stone formation.
However, the research doesn’t appear to support these hypotheses.
A 2016 meta-analysis investigating the impacts of low-carbohydrate diet on renal (kidney) function ultimately 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”.
In fact, they actually suggested a low-carb diet may be beneficial to kidney function thanks to its contributions to weight loss!
So, now that we better understand the arguments against a ketogenic diet and kidney health, let’s look into what other possible causes may be contributing to the discomfort.
Other possible contributors to kidney pain
Although we fairly debunked those two primary arguments against ketosis causing kidney pain, it isn’t to say that there may never be a link between the two.
However, here are the major contributors that you need to keep an eye out for. Note that, treatment requires accurate determination of the underlying cause so, if you’re not confident in identifying that cause, please seek a medical professional’s help!
Aside from kidney stones, you may suffer from discomfort/pain as a result of:
- Blood clots in the kidney - The most common cause of this clot is typically from another condition known as Nephrotic Syndrome. Nephrotic Syndrome is a condition in which large amounts of protein are lost in the urine, and blood flow then gets an increased tendency to form clots within the kidneys.
- Blunt force trauma to the lower back - Kidneys are located just in front of your lower back, and are very sensitive. If you get hit at the right angle, fall or suffer any other form of impact to that area, you can cause some serious damage to the structure of your kidneys (and may lead to you urinating blood in more extreme instances of trauma).
- Urinary Tract Infection (UTI) - A U.T.I leads and can cause fairly severe pain all the way up to the kidney along the urinary tract.
- Kidney infection - A kidney infection takes place when bacteria from an associated infection of the bladder has started to spread to the kidneys. Kidney infections cause a great degree of inflammation which in turn can contribute to the pain sensation, particular across the lower back.
What Does Kidney Pain on Keto Feel Like?
Kidney pain can be hard to pinpoint and distinguish from pain of the lower back.
There are some common associated symptoms however that come along with kidney pain (along with those we mentioned in the previous section unique to whichever condition you may be afflicted with)
The pain can feel like it’s taking place on the left or right side, dependent on whichever kidney is affected and may even end up affecting both if you’re particularly unlucky!
As we mentioned, if the pain is particularly severe and or you’re suffering from one or more of the following common symptoms of kidney pain we’d highly recommend you go see a medical professional.
- Painful urination
- Cloudy or bloody urine
- A persistent need to urinate
- Flank pain
Kidney Pain While Walking on Keto Diet
When walking, some may experience pain in what feels like their left kidney (typically described as a sharp pain or dull ache). You may even have an upper backache and for some the pain can spread to your stomach.
Left kidney pain may have nothing to do with the kidneys and if you’re experiencing pain in other parts of your body this may be more indicative of a separate issue!
Some of the primary culprits for pain in your lower left flank include:
- Muscular pain
- Muscular or Spine Injury
- Joint Pain
- Nerve Pain
If you’re experiencing severe pain in the lower left flank, we’d again have to advise you go see a medical professional. Always better to be safe than sorry!
What to Do About Kidney Pain on Keto?
Whilst it’s likely the source of your kidney pain is not related to keto, you can make certain changes to ensure that’s not the case (and making these changes may actually provide some benefit to the symptoms of the other conditions we’d mentioned!)
Eat less meat
As discussed, a high intake of animal-based proteins may influence the development of kidney stones.
It has long been known that vegetarian diets appear to have a protective effect against kidney stone disease with prevalence of kidney related issues being almost half that of those with an atypical western diet.
A vegetarian diet also has a high alkalinizing power on urines, leading to a higher urine pH, resulting in a lower risk for uric acid stones.
Vegetarian friendly, keto conducive, high protein sources you can incorporate into your diet to help you achieve your nutritional targets are;
- Full-fat tofu
- Nuts and Seeds
- Nut and seed butters
- Vegan high protein cheese (e.g. cashew cheese)
- Egg whites
Chronic dehydration is a risk factor for kidney stones. Many in the keto community suffer from dehydration unawares.
The dietary approach has many merits but many in the community do miss out on important minerals and don’t realize the increased demand for fluid and electrolyte intake – the two dominant dietary factors in hydration status.
Aside from the fact that many of the foods which are rich in electrolytes are now restricted (causing eventual deficiencies if not replaced elsewhere) the ketogenic diet’s effect on insulin levels also plays a very important role.
When insulin levels are lowered, glycogen stores deplete (following carbohydrate restriction) and water will be lost.
Insulin also plays an important role in sodium regulation within the kidneys. Low insulin leads to more sodium (and water) excretion by the kidneys.
Increasing your fluid intake, ensuring your urine is straw yellow to clear is a good start.
Of course, you can drink more water, but increasing your cruciferous vegetable intake and intake of other veggies lower in net carbohydrates but higher in fluids can also help greatly (and contributes to the previous point regarding a vegetarian approach!).
Using an electrolyte supplement may also be of benefit too and well worth a consideration for the convenience alone!
Take potassium supplements
Adequate potassium intake has been associated with a reduced risk of kidney stone development. Achieving adequate potassium intake is a challenge on the ketogenic diet.
The diet is naturally restrictive in food sources rich in potassium and may cause mineral imbalances due to inadequate food intakes (for example, when sodium is depleted the kidney excretes more potassium to compensate).
We wrote an article previously on this very subject and cover it in much more depth! In that article we’ve recommend a number of products which would be of benefit to supplement with. Here’s one or two of those which we recommended that we personally use:
Kidney bean broth
Kidney beans are naturally rich in magnesium, a mineral associated with reduced risk of kidney stone development and improving symptoms of kidney stones.
Drinking kidney bean broth will help you increase your magnesium intake but having the broth will also minimize carbohydrate intake (which beans are naturally rich in). It’ll also help you increase your fluid intake and improve your hydration status!
To make the broth simply strain the liquid from cooked beans and then drink a few glasses throughout the day!
Pain in the lower back can result from any number of reasons.
While the ketogenic diet has been touted as a possible detriment to kidney health, we’ve identified why that may not be the case however, have also highlighted how dietary inadequacies can impact kidney health and function.
The ketogenic diet is a fantastic weight loss program to follow for multiple health and performance related reasons.
However, it does require some planning to ensure you’re not missing out on certain important minerals and other beneficial dietary components that can have a protective effect on kidney health.
If you are experiencing severe pain and or discomfort, please go seek a professional’s advice.
We outlined some dietary changes and strategies you can implement but ultimately clinical intervention will always trump this. Always look after your body; after all, you’ve only got one!