Prevent Kidney Failure with Fasting / Keto [Avoid Dialysis!]

Kidney disease is really common, and often leads to kidney failure. 

Once you have kidney failure, you have to do dialysis treatments, which have a variety of downsides. 

They’re expensive, time-consuming, and your health and quality of life go downhill fast. 

The bad news is that kidney failure is NOT reversible. 

The good news?

In many cases, kidney failure can be prevented through some combination of fasting and/or a low-carb diet.

In this post I’ll explain my personal experience treating patients with kidney failure, what causes kidney failure, and what you can do to prevent kidney failure. 

Let’s dive in

My Experience with Dialysis Patients

Dialysis is that “blood filtering” treatment people with kidney failure have to do. Usually for 4 hours at a time, about 3 times per week. 

If you don’t work in healthcare, you might not run into people on dialysis very often. I run into them all the time, in the ER. 

At my old job, I used to see several dialysis patients every shift. We had a lot of undocumented immigrants who had nowhere else to go besides the hospital to get their dialysis. 

My role was to medically clear them before each dialysis treatment. The hospital was so busy that a lot of times these people ended up waiting another 10+ hours after I screened them, before they could get their treatment. So they’d hang out in the waiting room, go get some food and come back, or whatever. 

Most of them had to do this whole rigamarole 3 times per week. It was quite the crazy time commitment, but they had no choice. 

Without dialysis, they would die. 

Some of those patients were really young, too. Like in their 20’s and 30’s. The whole thing is a sad affair.

Kidney Failure: Stats and Life Expectancy

The section above probably gives you an idea how unpleasant it can be to need dialysis treatments. 

Even if you don’t have to wait 10 hours in the waiting room, it’s still time-consuming. 

And once you have kidney failure, it puts you at a higher risk of tons of other health problems. So much so, that the life expectancy with kidney failure is only 3 years!

(That was according to a Freakonomic podcast I heard a couple years ago–other estimates are a little higher, like 5-10 years.)

In the United States, there are about 37 million people with chronic kidney disease. This means their kidney function is getting worse little by little. 

The number of people with kidney failure is smaller – a little less than a million. But Medicare spends about $35 billion per year on this group of people.

Can’t I Just Get a Kidney Transplant?

You may be thinking, if my kidneys fail, I can just get a kidney transplant. 

The first problem with that line of thinking is that there aren’t enough kidneys available for everyone who needs transplants. The waitlist can be really long. 

Even if you do get a kidney transplant, that’s no walk in the park either. After your transplant, you’d be on a bunch of medications that suppress your immune system, putting you at higher risk for infections, not to mention cancer. And those medications have other side effects, too. 

Sometimes I see kidney transplant patients in the ER. We always have to worry a bit more about them, and they more frequently end up getting admitted to the hospital for a variety of reasons. 

The bottom line?

Neither kidney failure nor having a kidney transplant is ideal. Either way, it’s a pretty big burden and can lead to a variety of challenges.

Preventing Kidney Failure through Fasting and/or Keto.

Overall, I’ve painted a pretty grim picture about kidney failure.

(If anyone reading this is on dialysis, sorry to rub it in.)

But here’s the good news: 

Although kidney failure is a major downer, it’s also very preventable in most cases.

By far, the most common causes of kidney failure are:

1. Type-2 diabetes
2. High blood pressure

(There are other causes too, but they’re much less common. So I’ll focus on the big ones.)

The root cause of both diabetes and high blood pressure – in most cases – is high insulin (aka “insulin resistance”).

Why does your insulin get high?

Basically, some combination of eating (or drinking) too much sugar and processed carbs, or eating them too often, is generally what leads to high blood sugar and high insulin.

Then your body becomes resistant to insulin, which is called insulin “resistance”.

(For more details about insulin resistance, check out my detailed summary of Dr. Ben Bikman’s book, “Why We Get Sick”.) 

Among the downstream effects are that your kidneys hold on to more salt and water (causing high blood pressure), and insulin doesn’t work as well in your body, so your blood sugar stays high more often (causing type-2 diabetes).

What Can You Do about Excess Insulin?

If you stop and think about it, it’s really pretty simple. 

If the problem was caused by eating too much sugar and starch, or eating those things too often… 

Then if you do the opposite, things will probably get better. 

Basically, if you cut out processed sugar and other refined carbs, that would be called the ketogenic diet. 

And if you spend some time not eating, that would be called fasting. 

In either case, your insulin will probably go down, closer to the normal level. 

It sounds simple, but it works. And more often than not, type-2 diabetes and high blood pressure can be prevented (or reversed) through these simple measures. 

You know what else? 

It means kidney failure can usually be prevented through the same simple measures. Unlike diabetes and high blood pressure though, kidney failure is not reversible. So it’s best if you focus on preventing kidney failure (by preventing insulin resistance, and all the downstream effects).

I don’t know about you, but one of the things that motivates me the most to take better care of my health is when I hear about how I can easily prevent common (and often horrific) medical conditions, such as kidney failure.

So if you’re not on dialysis now, try to keep it that way.

Related Questions

Here are a few other questions that come up about fasting & kidney failure.

Can Fasting Reverse Kidney Failure?

In most cases, probably not.

Kidney failure is generally not reversible. Once the damage is done, the kidneys don’t really regenerate–for the most part.

A possible exception would be when there’s a more transient type of kidney “failure”. We see this in the ER sometimes, when somebody gets really dehydrated, or has some other type of temporary problem that basically makes their kidneys “shut down”.

Sometimes those people get better.  And fasting may be able to help them recover (when done on the right timeline, with the right medical supervision, etc.).

But for people who have a long, gradual road to kidney failure (like most diabetics and people with high blood pressure), the damage is usually not reversible. 

Does Dry Fasting Cause Kidney Failure?

Dry fasting means not drinking any water while you fast.

One of the potential dangers of dry fasting is getting dehydrated–it seems kind of obvious when you think about it.

Excessive dehydration can lead to what we call “acute kidney injury” in the medical field.  Basically it means a person’s kidney function gets worse in a short amount of time, usually indicated by an elevated creatinine level in the blood.

I haven’t personally seen it, but it wouldn’t be at all surprising if this happens to people who are doing dry fasting, on some occasions.  Basically if they go too long.

So be cautious.

Does Water Fasting Cause Kidney Failure?

Probably not.

Since you would still be drinking water during “water fasting”, you’re basically staying hydrated.

However, if you drink too much water without taking any electrolytes, you could get low on your electrolyte levels (like sodium, potassium, or magnesium). Basically, the water gradually dilutes your blood, so the electrolyte levels get lower.

So for most people it’s better to take water and electrolytes together, during a fast. 

If you consume the right balance of water and minerals, your kidneys will probably continue to function just like normal during your fast.

(As always, none of this is individual medical advice. So consider your personal circumstances.)

Final Thoughts: Preventing Kidney Failure through Fasting and/or Keto

Kidney disease is common, and often leads to kidney failure. 

The main causes of kidney failure are diabetes and high blood pressure. Luckily, both type-2 diabetes and high blood pressure are usually preventable (or reversible) through diet and lifestyle. 

Among the most effective treatments are intermittent fasting and/or a ketogenic diet.

If you want to learn how to get started with intermittent fasting, check out my Intermittent Fasting Checklist, which helps you get off on the right foot.

If you want to get started with keto, check out my podcast episodes about Keto for Beginners, and What to Eat on Keto (or the related blog posts: Keto 101, and 47 Quick & Easy Keto Foods).