Study Design
Systematic review using the SWiM (Synthesis Without Meta-Analysis) approach. Searched three databases for human studies of ketogenic dietary interventions in ADPKD. Risk of bias assessed using Cochrane RoB 2.0, Newcastle-Ottawa scale, and ROBINS-I tool.
Intervention
Reviewed 8 studies employing ketogenic diets, intermittent fasting, and time-restricted feeding in ADPKD patients.
Key Results
Weight/Anthropometrics: Consistently improved
KDIs linked to weight loss and improved anthropometric profiles across 9 of the reviewed interventions.
Blood Pressure: Unchanged in most
Blood pressure remained stable in 5 interventions. Lipids (cholesterol, HDL, LDL, triglycerides) also unchanged — confirming safety.
eGFR: Improved or stable
eGFR was higher in 4 interventions or stable after intervention. No studies showed eGFR decline.
htTKV: Inconsistent
Evidence for renal structural change was inconsistent, limited by short intervention duration and small sample sizes.
Context & Comparison
This is the first formal systematic review of all ketogenic interventions in ADPKD, synthesizing evidence from KETO-ADPKD, RESET-PKD, Juntendo, Ren-Nu, TRE, and other studies.
Significance
The review confirms that ketogenic interventions are metabolically feasible and safe in ADPKD — no adverse effects on lipids, kidney function, or blood pressure. Current evidence supports metabolic feasibility more consistently than renal disease modification. The authors emphasize that longer trials with appropriate comparators are needed before KDIs can be formally recommended. Notably, the review was published before the Juntendo 12-month data (WCN 2026) which subsequently demonstrated significant TKV reduction.