If we equate de facto ketogenic diets with high -
protein diets (which is not always
correct) then the risks proposed by critics
of this
type of dietary approach are essentially those
of possible kidney damage due to high levels
of nitrogen excretion during
protein metabolism, which can cause an increase in glomerular pressure and hyperfiltration.12 There is not wide agreement between studies; however, some infer the possibility
of renal damage from animal studies, 99, 100 whereas others, looking at both animal models, meta - analyses and human studies, propose that even high levels
of protein in the diet do not damage renal function.101, 102 In subjects with intact renal function, higher dietary
protein levels caused some functional and morphological adaptations without negative effects.103 There may actually be renal - related effects, but on blood pressure rather than morphological damage.