Ketogenic Dietary Interventions in Autosomal Dominant Polycystic Kidney Disease (ADPKD)

A mild reduction in food intake significantly inhibits renal cyst growth in mouse models of ADPKD. The underlying mechanism was unknown at the time. Recently published data show that the beneficial effect is not due to caloric restriction per se but due to the induction of the state of ketosis. Dietary interventions leading to ketosis profoundly inhibited renal cyst growth in rodent models of PKD. In addition, acute fasting led to rapid regression of renal cystic burden in mouse, rat and feline models of PKD. Due to these compelling effects in a multitude of PKD animal models, and due to the fact that well-established dietary interventions have a tremendous translational potential, KETO-ADPKD will test such interventions regimens in ADPKD patients. Two well-established ketogenic dietary regimens will be tested in comparison to a control group to address the following four questions: 1. Feasibility: Are ketogenic dietary interventions acceptable to ADPKD patients in everyday life? 2. Safety: Are there adverse events of ketogenic dietary interventions in ADPKD patients? 3. Efficacy: Do the dietary interventions reach the metabolic endpoints? Do they have a short-term impact on kidney volume? 4. Which of the two diets is the optimal approach? These questions will be addressed in an exploratory, randomized, open, single center, three-arm dietary intervention study using the following interventions in 21 ADPKD patients per treatment arm: A) Ketogenic diet B) 3-day water fasting C) Control: ad libitum food intake (no diet)