How does a ketogenic diet affect kidney stones?

By Dr. Stephen Phinney and the Virta Team‍

Our clinical experience is that kidney stones are rare during a well-formulated ketogenic diet.

Kidney stones have many causes. The most common chemicals found in kidney stones are calcium, oxalate, and uric acid. Significant promoters of kidney stone formation are genetic (aka inherited) factors, dehydration, and low dietary magnesium. Although serum uric acid levels go up in the early adaptation phase of a well-formulated ketogenic diet, this is caused by decreased excretion, not increased production. And after a month or two, the kidneys adapt to maintaining normal uric acid excretion. At Virta, we devote considerable attention to hydration, adequate but not excessive dietary sodium and calcium, and despite plenty of green vegetables, nut, and seeds (dietary sources of magnesium), we supplement magnesium when there are early clinical signs of depletion.