The Development of KetoCitra®
After years of research and development, Santa Barbara Nutrients has now launched its first product, a medical food called KetoCitra®, designed for the dietary management of individuals with PKD (Polycystic Kidney Disease). University of California professor Dr. Thomas Weimbs, a recognized leader in the PKD research field, and Dr. Jacob Torres, current Head Researcher of Santa Barbara Nutrients (SBN) discovered that a combination of two natural compounds, beta-hydroxybutyrate (BHB) and citric acid (citrate), can aid in the nutritional management of PKD by addressing the metabolic abnormalities that manifest during the progression of the disease.
Given the limited pharmacological offerings for PKD, Weimbs and Torres decided
to utilize their research findings to provide an approach to
managing PKD through dietary interventions.
Dr. Thomas Weimbs, UC Santa Barbara molecular biologist, has directed a research laboratory for more than 20 years focusing on the molecular mechanisms that underlie PKD. Most recently, two significant discoveries emerged that pointed to dietary approaches in the management of PKD.
1. Crystals: What was previously an unknown mechanism, the Weimbs lab discovered that micro-crystals that can precipitate in renal tubule lumens lead to activation of signaling pathways, tubule dilation and acceleration of cystic progression. These crystals (such as calcium oxalate, calcium phosphate and uric acid) frequently form in human kidneys and are exacerbated by dietary intake of oxalate, phosphate and purines, as well as the metabolic abnormalities common in individuals with PKD leading to low urine pH and hypocitraturia.
KetoCitra® helps with the dietary management of renal crystal precipitation by…
- Normalizing urine pH by providing 51 mEq alkaline base per day.
- Normalizing urine citrate levels by providing citrate.
- Suppressing the dietary uptake of oxalate and inorganic phosphate by providing calcium and magnesium.
Torres JA, Rezaei M, Broderick C, Lin L, Wang X, Hoppe B, Cowley BD, Savica V, Torres VE, Khan S, Holmes RP, Mrug M, Weimbs T. Crystal deposition triggers tubule dilation that accelerates cystogenesis in polycystic kidney disease. J Clin Invest. 2019; 130:4506-4522.
2. Ketosis: Cyst cells in PKD display metabolic abnormalities that lock them in a glycolytic state and make them unable to metabolize fatty acids and ketones. These cells are dependent on blood glucose for energy. The Weimbs lab discovered that dietary interventions that promote the metabolic state of ketosis strongly slow the progression of PKD in multiple animal models, and that the effect can be mimicked by supplementing the diet with the ketone beta-hydroxybutyrate (BHB). Based on these results and numerous clinical data, carbohydrate-predominant diets consumed by most individuals in industrialized societies likely worsen the progression of PKD.
KetoCitra® helps with the dietary management of metabolic abnormalities in PKD by…
- Raising blood BHB levels by providing exogenous BHB.
Torres JA, Kruger SL, Broderick C, Amarlkhagva T, Agrawal S, Dodam JR, Mrug M, Lyons LA, Weimbs T. Ketosis Ameliorates Renal Cyst Growth in Polycystic Kidney Disease. Cell Metabolism. 2019; 30:1007–1023.https://pubmed.ncbi.nlm.nih.gov/31631001/
Pickel, Lauren, Ioan-Andrei Iliuta, James Scholey, York Pei, and Hoon-Ki Sung. “Dietary Interventions in Autosomal Dominant Polycystic Kidney Disease.” Advances in Nutrition, no. nmab131 (November 10, 2021). https://doi.org/10.1093/
The Weimbs lab discovered that combining BHB with citrate provides synergistic beneficial effects that allows lower amounts of each component to be used for improved tolerance.
While KetoCitra® can be taken by itself, it is recommended to be used in conjunction with supportive dietary and lifestyle changes. SBN has collaborated with highly experienced renal dietitians from the non-profit company RenAlign to create the Ren.Nu dietary program for PKD (ren-nu.org) that is now available for patients.