Incidence and risk factors of ketogenic diet-associated nephrolithiasis in children with drug-resistant epilepsy: A tertiary care center experience.
Ketogenic diet was associated with renal stones in 13.8% of children with epilepsy.
Incidence and risk factors of ketogenic diet-associated nephrolithiasis in children with drug-resistant epilepsy: A tertiary care center experience.
The ketogenic diet (KD) is a recognized non-pharmacological treatment option for children with drug-resistant epilepsy (DRE).
This study aimed to describe the incidence, clinical characteristics, and factors associated with renal stones in pediatric patients treated with KD or modified Atkins diet (MAD), and to characterize stone management strategies and clinical outcomes.
This retrospective cohort study was conducted at the Pediatric Neurology Clinic of King Fahad Specialist Hospital-Dammam (KFSHD).
Patients who developed renal stones were older at KD initiation (p = 0.025) and were more frequently treated with higher ketogenic ratios (≥3:1), although this difference did not reach statistical significance (p = 0.071).
Management was predominantly conservative, and four patients required interruption of KD, with no patients requiring surgical intervention.
A clinically meaningful seizure reduction (>50%) was observed in 60% of the cohort.
In this single-center cohort of children with DRE, KD was generally well tolerated and associated with meaningful seizure reduction.
Renal stones occurred in a subset of patients, were frequently asymptomatic, and were managed conservatively. Older age at diet initiation was associated with stone formation.
Higher ketogenic ratios showed a non-significant trend toward increased risk of renal stones.