Abstracts

Long-term Effects of the Ketogenic Diet on Bone Health and Kidney Stone Formation in Pediatric Patients

Abstract number : 2.004
Submission category : 10. Dietary Therapies (Ketogenic, Atkins, etc.)
Year : 2024
Submission ID : 1292
Source : www.aesnet.org
Presentation date : 12/8/2024 12:00:00 AM
Published date :

Authors :
Presenting Author: Khaled Al-Robaidi, MD – Cleveland Clinic Foundation

Pongkiat Kankirawatana, MD – University of Alabama at Birmingham
Ambika Ashraf, MD – University of Alabama at Birmingham
Monica McChesney, MS, RDN – Children's of Alabama
Ismail Mohamed, MD – University of Alabama at Birmingham

Rationale: The ketogenic diet is a well-established treatment for refractory epilepsies and various metabolic disorders. However, its long-term impact on bone metabolism and kidney stone formation remains an area of ongoing research, with studies showing mixed results. This study aimed to explore the long-term outcomes related to bone health and kidney stone formation in patients who have been on the ketogenic diet for over 2 years.

Methods: We performed a retrospective chart review of patients followed by the ketogenic diet clinic at Children's of Alabama who were maintained on the diet for over 2 years. Several parameters were collected, including patient demographics, diagnoses, bone density DXA scan scores, incidence of fractures while on the diet, bisphosphonate therapy, and renal ultrasound results. For patients with multiple lumbar DXA scans, we compared the Z-scores of the first and second scans.


Results: Our initial sample included 28 patients who had at least one DXA scan while on the ketogenic diet for over 2 years, with a mean age at diet initiation of 5.86 ± 5.16 years. The average time from diet start to the first DEXA scan was 4.87 ± 2.63 years. The mean lumbar Z-score at the first scan was -1.86 ± 1.74. Four patients (14.3%) suffered a fracture while on the diet, and four patients (14.3%) were found to have kidney stones. In the subset of patients with at least two lumbar DXA scans (N=17), the average interval between scans was 1.65 ± 0.95 years. For patients who did not receive bisphosphonates (n=11), the mean Z-score changed from -1.11 to -1.35 (p = 0.752). For those who received bisphosphonates (n=6), the mean Z-score improved from -3.55 to -2.05 (p = 0.070).


Conclusions: In our sample, patients on long-term ketogenic diets showed low bone mineral density, with a significant portion experiencing fractures and kidney stones. Mean DXA scan Z-scores suggested improvement in those receiving bisphosphonate therapy, though not statistically significant. These findings emphasize the need for ongoing monitoring and management of bone health and renal complications in these patients.


Funding: N/A

Dietary Therapies (Ketogenic, Atkins, etc.)