Polycystic Kidney Disease Breakthrough (New Research in PKD) - 2024

Summary

Dr. Ken Barry discusses a groundbreaking study on polycystic kidney disease (PKD), suggesting a ketogenic diet and intermittent fasting may slow its progression and improve kidney function. He emphasizes the lack of scientific evidence supporting common dietary restrictions for PKD and highlights the importance of avoiding sugary drinks and maintaining low insulin levels. The video provides actionable dietary advice for those affected by or at risk of PKD, urging viewers to consider the new research before following traditional medical guidance.

Takeaways

• 🧬 Polycystic kidney disease (PKD) is the most common inherited kidney disease, characterized by enlarging cysts in the kidneys that can lead to decreased kidney function and the need for dialysis.
• 👨‍👩‍👧‍👦 PKD is a genetic condition, so family history is important. If relatives had unexplained kidney disease, individuals should consider getting tested.
• 🚨 Symptoms of PKD can include decreased kidney function, urinary tract infections, kidney stones, and blood in urine, but also non-kidney related signs like high blood pressure and liver cysts.
• 🐀 Previous animal studies have shown that ketosis can slow down or improve PKD, and a new human study supports these findings.
• 🥗 A ketogenic diet, which is high in fat and low in carbs, is suggested to potentially prevent or slow the progression of PKD.
• ⏱ Intermittent fasting, or time-restricted eating, may also play a role in managing PKD by potentially improving kidney function.
• 📉 A recent randomized control trial in humans found that a ketogenic diet can reduce the size of polycystic kidneys and improve kidney function.
• 🚫 The PKD Foundation's website does not yet reflect the new findings, still suggesting the DASH diet without research support for PKD.
• 🍖 Contrary to common medical advice, there is no research supporting the idea that limiting protein, red meat, or caffeine is beneficial for PKD.
• 🍹 Alcohol should be avoided, especially sugary drinks, as they can spike blood sugar and potentially worsen PKD.
• 💊 Supplements like potassium or magnesium citrate may slow down the progression of PKD, and smoking should be avoided for overall health.

Q & A

What is polycystic kidney disease (PKD)?

Polycystic kidney disease is the most common inherited kidney disorder, characterized by the development of enlarging cysts in the kidneys, which can eventually lead to decreased kidney function and may require dialysis.

Why is it important to be aware of family history in relation to PKD?

A family history of kidney disease can indicate a genetic predisposition to PKD, making it crucial for individuals to get checked if they have relatives who had unexplained kidney issues, as early detection can help manage the condition more effectively.

What are some signs and symptoms that might indicate PKD?

Signs and symptoms of PKD include decreasing kidney function, repetitive urinary tract infections, kidney stones at a young age, blood in urine, high blood pressure without an apparent cause, liver cysts, diverticulosis, and unexplained abdominal or flank pain.

How have animal studies contributed to understanding PKD and its treatment?

Animal studies, particularly in rats and cats, have shown that ketosis can slow down the progression of PKD and improve kidney function, providing insights into potential dietary interventions for human patients.

What is the significance of the recent human study published in Cell Reports Medicine?

The study is significant as it is a randomized control trial in humans that found a ketogenic diet induced ketosis can shrink the size of polycystic kidneys and improve kidney function in people with PKD, offering a potential therapeutic approach.

What dietary recommendations are suggested for individuals with PKD based on the script?

The script suggests starting a whole food, one-ingredient ketogenic diet and implementing intermittent fasting to potentially prevent or slow down the progression of PKD.

What is the role of intermittent fasting in managing PKD according to the script?

Intermittent fasting, such as fasting for 16 to 18 hours a day and having one or two ketogenic meals within a 6 to 8-hour window, may help preserve kidney function and slow down the progression of PKD.

Why is avoiding sugary drinks and maintaining low blood sugar levels important for PKD patients?

High blood sugar levels can cause the cysts to grow faster in PKD patients, so avoiding sugary drinks and maintaining low blood sugar levels can help slow down the disease progression.

What are some common misconceptions about diet and PKD that the script aims to clarify?

The script clarifies misconceptions such as limiting protein or red meat intake, reducing salt, and avoiding caffeine, which are not supported by research and may not be beneficial for PKD patients.

How does the script differentiate between the PKD Foundation's recommendations and the research findings?

The script points out that the PKD Foundation's recommendations, such as the DASH diet, are not based on research specific to PKD, whereas the script's recommendations are based on animal studies and a human randomized control trial.

What lifestyle changes are advised for individuals at risk of PKD or those who have it?

The script advises individuals at risk of PKD or those who have it to adopt a ketogenic diet, practice intermittent fasting, avoid alcohol and smoking, and maintain a normal water intake to keep urine light yellow, which can help manage the condition.

Outlines

00:00

🧬 Polycystic Kidney Disease (PKD) Breakthrough

Dr. Ken Barry introduces a breakthrough in the management of polycystic kidney disease (PKD), the most common inherited kidney disease. He explains the hallmark symptom of enlarging cysts in the kidneys and the risk factors, including family history. Dr. Barry also discusses early signs and symptoms of PKD, such as decreased kidney function, urinary tract infections, and unexplained blood in urine. He highlights the potential benefits of ketosis and time-restricted feeding in slowing down the progression of PKD, based on studies in animals, and introduces a recent human study that supports these findings.

05:02

🥗 The Impact of Ketogenic Diet on PKD

This paragraph delves into the results of a human randomized control trial published in November 2023, which found that a ketogenic diet can reduce the size of polycystic kidneys and improve kidney function in PKD patients. Dr. Barry emphasizes the importance of starting a ketogenic diet early and possibly combining it with time-restricted eating to prevent or slow down the progression of PKD. He also expresses disappointment with the PKD Foundation's recommendations, which do not align with the new research findings.

10:04

🚫 Debunking Common Misconceptions about PKD Diet

Dr. Barry addresses and refutes several common dietary recommendations for PKD patients that lack scientific evidence, such as limiting protein, red meat, salt, and caffeine intake. He suggests that these recommendations are not based on research and instead advises against alcohol consumption, especially sugary drinks, to prevent spikes in blood sugar that could accelerate PKD progression. He also mentions the potential benefits of potassium or magnesium supplements and the importance of avoiding smoking.

15:06

🍽 A Day of Eating for PKD Patients

In the final paragraph, Dr. Barry provides a detailed dietary plan for individuals with PKD or at risk of developing it. He recommends a whole food, one-ingredient ketogenic diet with two meals a day or one large meal, emphasizing the importance of high-quality protein and healthy fats. He also advises against snacking between meals to maintain low blood sugar and insulin levels. Dr. Barry concludes by encouraging viewers to share the video with those affected by PKD and to consult the research provided in the show notes for further information.

Keywords

💡Polycystic Kidney Disease (PKD)

Polycystic Kidney Disease is the most common inherited kidney disorder characterized by the growth of multiple cysts in the kidneys. It is central to the video's theme as it discusses the disease's impact, symptoms, and potential dietary interventions to manage or slow its progression. The script mentions that PKD can lead to decreased kidney function, increased risk of kidney failure, and the need for dialysis.

💡Ketosis

Ketosis is a metabolic state in which the body burns fat for energy instead of carbohydrates. The video discusses how ketosis, achieved through a ketogenic diet, has been shown in studies to potentially slow the progression of PKD and improve kidney function. The script cites a recent human study that supports the benefits of ketosis in managing PKD.

💡Ketogenic Diet

A ketogenic diet is a high-fat, low-carbohydrate diet that prompts the body to enter a state of ketosis. The script emphasizes the importance of a ketogenic diet in the management of PKD, suggesting that it can shrink kidney cysts and improve kidney function, as supported by both animal and human studies.

💡Intermittent Fasting

Intermittent fasting is an eating pattern that cycles between periods of eating and fasting. The video suggests that intermittent fasting, such as eating within a 6- to 8-hour window, may complement a ketogenic diet to further support kidney health in individuals with PKD, based on its potential benefits observed in animal studies.

💡Cysts

Cysts are fluid-filled sacs that can develop in various parts of the body, including the kidneys in the case of PKD. The script describes how the hallmark of PKD is the presence of enlarging cysts in the kidneys, which can eventually lead to kidney function decline and other complications.

💡Dialysis

Dialysis is a medical procedure that performs the functions of the kidneys when they can no longer do so effectively. The video mentions dialysis as a potential consequence of advanced PKD, highlighting the importance of managing the disease to delay or prevent the need for this treatment.

💡Genetic Predisposition

Genetic predisposition refers to the increased likelihood of developing a particular health condition due to inherited genes. The script discusses the hereditary nature of PKD and the importance of genetic testing for individuals with a family history of kidney disease.

💡Randomized Control Trial (RCT)

A randomized control trial is a type of scientific experiment that compares the effects of an intervention against a control group to determine its efficacy. The video highlights a recent RCT in humans that supports the benefits of a ketogenic diet in managing PKD, adding credibility to the dietary recommendations.

💡Dietary Intervention

Dietary intervention refers to the use of specific dietary changes to manage or treat a health condition. The video's main theme revolves around dietary interventions, particularly the ketogenic diet and intermittent fasting, as potential strategies for managing PKD.

💡DASH Diet

The DASH (Dietary Approaches to Stop Hypertension) diet is a diet rich in fruits, vegetables, and low-fat dairy products, designed to lower blood pressure. The script contrasts the DASH diet with a ketogenic diet, noting that the former lacks research support for managing PKD, unlike the latter.

💡Protein Intake

Protein intake refers to the consumption of protein-rich foods. The video counters common misconceptions by stating that high protein intake, including red meat, is not detrimental to kidney health in PKD and may even be beneficial, contrary to some medical advice.

Highlights

Polycystic kidney disease (PKD) is the most common inherited kidney disease, characterized by enlarging cysts in the kidneys that can lead to kidney failure and the need for dialysis.

PKD can be inherited, so family history of kidney disease should prompt individuals to get checked for the condition.

Early symptoms of PKD include decreasing kidney function, urinary tract infections, kidney stones, and blood in urine.

Non-kidney related symptoms such as high blood pressure, liver cysts, and abdominal hernias can also indicate PKD.

Animal studies have shown that ketosis can slow down the progression of PKD and improve kidney function.

Intermittent fasting, like feeding animals once a day, has been linked to improved kidney health in PKD models.

A recent human study in November 2023 demonstrated that a ketogenic diet can shrink kidney size and cysts in PKD patients.

The study suggests that a ketogenic diet and time-restricted eating could prevent or slow down PKD progression.

The PKD Foundation's website does not currently recommend a ketogenic diet or intermittent fasting despite the study findings.

Genetic testing can identify predisposition to PKD, which is crucial for early intervention.

A whole food, one-ingredient ketogenic diet is recommended for those with or at risk of PKD.

Intermittent fasting, with 16-18 hours of fasting and a 6-8 hour eating window, is suggested to protect kidney function.

Common medical advice such as limiting protein, red meat, and caffeine is not supported by research for PKD management.

Potassium or magnesium supplements may help slow down PKD progression, as suggested by some research.

Alcohol, especially sugary drinks, should be avoided as it can worsen PKD by increasing blood sugar and cyst growth.

Smoking is detrimental to health and should be avoided, although its direct link to PKD progression is not established.

A sample day of eating for someone with PKD includes two ketogenic meals with a focus on protein and low-carb vegetables.

The dietary recommendations are based on research across multiple species and a recent randomized control trial in humans.

The video emphasizes the importance of following evidence-based dietary changes for PKD management.

Transcripts

I've been researching polycystic kidney

disease for over 4 years now and there's

a recent breakthrough randomized control

trial study in humans that is going to

revolutionize the way that people with

polycystic kidney disease or their loved

ones take care of themselves in the

future I'm Dr Ken Barry a family

physician let's talk about polycystic

kidney disease it is the most common

inherited kidney disease in modern

society the Hallmark finding of

polycystic kidney disease is enlarging

cysts in the kidney that eventually take

over the entire kidney if the disease is

not managed and decreasing kidney

function it's one of the leading causes

of inst stage kidney diseases and the

need for dialysis as well this is an

inherited condition of the kidney so if

you have any parents grandparents or

anyone in your family back up your

family tree who had some weird kidney

disease that caused them to die early

then this is something you should

probably get checked for because most

young people have no idea they have

polycystic kidney disease until the

symptoms start and at that point a lot

of damage has already been done the

signs and symptoms to look for are

decreasing kidney function when your

doctor checks for your kidney function

repetitive urinary tract infections

having a kidney stone young in Life or

having multiple kidney stones uh also

blood in your urine for no apparent

reason now there are some signs and

symptoms that have nothing to do with

your kidney so if you've had any of

these then you probably need to see your

doctor and get checked for polycystic

kidney disease as well and that includes

high blood pressure for no real reason

especially young in life uh left

ventricular hypertrophy any kind of cyst

on your liver yeah

diverticulosis a lot of people with

diverticulosis don't understand that

there's a there's a potentially related

kidney disease as well abdominal hernas

for no real reason inguinal hernas for

no real reason or just abdominal or

flank pain any of these can be early

morning signs of polycystic kidney

disease now for years researchers have

known in studies in Rat studies and in

cat studies that being in ketosis slowed

down the progression and in many cases

actually improved kidney function in

these animals that they used as

polycystic kidney disease models and so

most animals in research studies are fed

once a day because you've got these

animals in a cage and you don't want to

spend all day feeding them three meals a

day with snacks in between so you feed

them once a day now a lot of the early

studies with rodents this once a day

method of feeding they would restrict

their calories as well and so they

initially thought well it's because of

the calorie restriction but what some

smart researchers said well you know

you're only feeding them once a day so

actually what you're also doing is a

Time restricted feeding Model A so it

could be that the intermittent fasting

of the animals eating one meal a day

that could be improving their kidney

function and slowing down polycystic

kidney disease progression it could be

the fasting and indeed we now have a new

study looking at polycystic kidney

disease in hum a randomized control

trial and we're going to talk about that

trial in just a second so that you can

understand the good news that this study

gives us but you have to first

understand that even back in 2019 it was

well known when studying animal models

that the animals being in ketosis

prevented polycystic kidney disease or

reversed polycystic kidney disease it

actually Shrunk the size of the cyst and

it improved the kidney function of these

animals now if in the animal models of

polycystic kidney disease both Tim

restricted feeding which in humans we

would call intermittent fasting slow the

progression and improve kidney function

and feeding them a diet that put them

into a therapeutic state of ketosis in

humans this would be analogous to eating

a ketogenic diet actually decreased the

progression and improved kidney function

and decrease the size of the cysts in

the the kidneys of these animals that

they were using to model polycystic

kidney disease now on to the new study

published in November of 2023 in cell

reports medicine this was a randomized

control trial in humans so this is the

study that I've been waiting four years

to happen so that I could actually make

a video about polycystic kidney disease

and what you should do about it and what

you should not do about it in this

randomized control trial they found that

being in ketosis because you're eating a

ketogenic diet Shrunk the size of

polycystic kidneys Shrunk the size of

the cysts and improved the function of

kidneys from people suffering from

polycystic kidney disease this is a

human study not an animal study and it's

a randomized control trial so it's

really hard for anybody to argue at this

point that if you have polycystic kidney

disease or you had a a loved one a

father mother grandparent who had

polycystic kidney disease and you're at

risk because it is genetically

transmitted the

predisposition if you start a ketogenic

diet early enough in life and then going

from the animal models also includes

some degree of Tim restricted eating

eating in a a six-hour window so having

one or two meals a day and making those

one or two meals a day a ketogenic diet

type meal very very low in carbohydrates

you are most likely to be able to

prevent polycystic kidney disease from

ever rearing its ugly head in your life

at the best now at the very worst case

scenario is that your polycystic kidney

disease is going to progress much less

slowly you're going to have much less

kidney damage done you're going to

preserve kidney function for years

longer than you would have have done

otherwise if you were eating the the

standard Western diets and you're going

to put off having to be on dialysis due

to endstage renal disease you could

potentially put that off by DEC AES by

eating a ketogenic diet very strictly

and by doing some degree of Tim

restricted eating now I was super

excited about these findings and so I

rushed over to the PKD foundation's

website figuring that they'd already

updated their website and we're

recommending a ketogenic diet and

intermittent fasting for everyone with

PKD and when I get to their site I find

that under nutrition they say there's

really no evidence that any Di dietary

intervention has any effect on it and

they go on later on the page to

recommend the DASH diet which there's

literally no research that that in any

way protects kidney function if you have

polycystic kidney disease so I'm not

real sure what I got that from let me

kind of sum up everything we know about

polycystic kidney disease so far and

everything that you should do and should

not do if you have polycystic kidney

disease or if you are the child or the

grandchild of someone who had polycystic

kidney disease now there are genetic

tests for this but most doctors don't do

them very often and and would have to

look it up to see what the test is but

if you are at risk if you think well you

know great granddaddy had that weird

kidney disease nobody could figure out

you should probably talk to your doctor

about getting tested genetically to see

if you have a predisposition for

polycystic kidney so now the question

what should I do what should I not do if

I have PKD or if I think I might have

the G genes that predispose me to PKD so

the first recommendation based on not

only animal studies and three different

species of animal plus now a randomized

control trial in human beings if you

have PKD or suspect that you do you

should immediately start a whole food

real one ingredient ketogenic diet I've

got a ton of videos on my YouTube

channel here about what a ketogenic diet

is and how to do that in a healthy

manner you should also Implement some

degree of intermittent fasting whether

that's you you fast for 16 hours a day

and then have an 8 Hour feeding window

where you eat two ketogenic meals a day

you could even tighten that up even more

if you really wanted to put off the

disastrous complications that come from

PKD you could fast for 18 hours a day

and then have two meals in a 6-hour

window or then some people love just

eating one meal a day that's perfectly

appropriate if you have PKD or if you

have are at risk of it is to just eat

one ketogenic meal a day and then fast

for the remainder of the day now keep in

mind that a carnivore diet is a subset

of a ketogenic diet and it's going to

keep you in ketosis for the vast

majority of the day so if you're like

well I love meat and eggs I could just

eat one huge meat and egg meal a day and

be very happy absolutely that's going to

be very therapeutic for you if you have

PKD or are at risk of developing it now

things that doctors very often give

patients advice that's just wrong this

not based on any research whatsoever

there's no science that bears out these

recommendations is oh you should limit

the amount of protein that you eat or

limit the amount of red meat no research

back set up whatsoever number two oh you

should cut back on salt or limit your

salt or avoid salt again in PKD there is

zero research to recommend a low salt

diet to you that's not going to help you

at all next is oh you should either

drink lots of water or limit your water

intake the goal seems to be because of a

PKD you're at increased risk of kidney

stones right the goal seems to be is to

drink enough water each day so that your

urine is a very light yellow color you

don't need to drink enough water for it

to be completely clear like water you

also don't want it to be moderate or

dark yellow you want it to be light

yellow that's the sweet spot for

avoiding the kidney stones also you

don't want to overwork your kidneys by

just drinking too much unnecessary water

the next is caffeine a lot of docs will

tell you to limit caffeine or avoid

caffeine literally no research bears

that out if you want a cup of coffee in

the morning or a glass of unsweetened

tea at lunch absolutely there's no

problem with caffeine at all now there

is some research showing that potassium

citrate or magnesium citrate seems to

slow down the progression and so talk to

your doctor about a potassium or a

magnesium supplement and see if they

that they like that idea because that's

also something that's been shown in some

research to slow down the progression a

little bit what about alcohol you need

to avoid alcohol the worst thing you can

do in PKD is to have a sugary mixed

drink like a Manhattan or a Shirley

Temple or whatever your poison of choice

is you need to avoid all alcohol if you

want to have one drink on your birthday

or your anniversary that's probably fine

but it needs to be a sugar-free zeroc

carbohydrate drink because the thing

that's going to destroy your kidney

function and make the cyst grow faster

according to this research is if you

drink or eat anything that spikes your

blood sugar that increase of glucose in

your bloodstream is going to cause the

cyst to grow faster so you want to keep

your blood sugar as low normal as low as

you can keep it for as many hours a day

as you possibly can and the last thing

is if you're smoking right now come on

stop smoking that's dumb there's no

research showing that smoking hastens

PKD damage or causes in stage renal

disease quicker but we know smoking is

really bad for you so just don't do that

now on the PKD foundation's website they

list a couple of example days of eating

and since they recommend the DASH diet

which is based on no research for PKD

I'm not sure where they got these meal

recommendations from but I'm going to

give you just a day of eating for

somebody with PKD so you're going to

wake up and you're either going to have

breakfast and lunch or you're going to

have lunch and dinner you're going to

skip you're going to have just two meals

a day or you can have just one big meal

a day and both of those are ideal for

preventing the progression for

protecting your kidney function so

you'll wake up let's say you're going to

have breakfast and lunch and skip dinner

wake up you're going to have bacon and

eggs or steak and eggs for breakfast

remember the protein does is not bad for

your kidneys at all there's no research

to support that red meat is good for

your kidneys it's not bad for your

kidneys so if you want steak and eggs

every morning fine have at it and what

that's going to do the help healthy fat

and healthy protein are going to keep

you saet keep you full for many hours so

that it makes it much easier for you to

do the 16 or 18 hour intermittent fast

that you want to do every day to protect

your kidney function now the second meal

a day we'll say is lunch you could have

any kind of meat any kind of eggs with

the yolk always with the yolk and then

you could have a serving of low carb

vegetables with that you could have a

few low carb nuts with that and a few

low carb berries for your dessert and

what you definitely don't want to do is

snack in between meals you want to keep

your blood sugar and your insulin levels

as low as you can for as many hours a

day as you possibly can so now what if

you just want to eat one big meal a day

that meal of the day for me personally I

would have that in the afternoon because

that just works better for my life my

family my social but whatever meal of

the day works best for you you could

have as many eggs with bacon as many

eggs with steak you can have if you want

chicken that's fine if you want pork

that's fine but you're going to have

steak meat and egg

and that's it you're going to eat until

you can't eat another bite and then

you'll fast until the next day when you

eat that a meal like that again so now

keep in mind my dietary recommendations

are based on studies in mice in rats and

in cats and now a randomized control

trial in human beings the most important

animal at all of all when it comes to

you and your health as always I've

linked all the studies that I use to

make this video down in the show notes

below if you go to a a primary care

doctor or a kidney specialist and they

say limit meat limit protein limit

caffeine any of the stuff I talked about

here or to eat the DASH diet or to eat

you know a plant-based diet realize

immediately that their recommendations

are based on not a shred of research

whatsoever there is research in humans

in a randomized control trial showing

that a ketogenic diet which by

definition is going to include lots of

meat of some kind because you you if

you're not going to eat carbs you got to

eat something two meals a day or one

meal a day with somewhere between 16 and

22 hours of fasting each day that is

going to protect your kidney function

and add years to your life and keep you

off dialysis for potentially decades the

research is down in the show notes I

hope this video helps if you know

someone who has PKD or a family who's

had that I would share this video with

them so that they can start now before

the PKD gets out of hand and has done

permanent kidney damage hope this video

helps this is Dr Barry see you next time