Ketone bodies in kidney diseases: novel insights

Ketone bodies (KBs) are important energy fuels and play complex roles in the occurrence and development of diseases by regulating metabolism, inflammation, and multi-organ cellular crosstalk. The high mortality and morbidity of kidney diseases is an urgent global public health problem. The pathogenesis of kidney diseases is complex, with metabolic disorders underlying. Ketone body metabolism has recently become a hot spot, and ketogenic diets (KDs), sodium-glucose cotransporter 2 inhibitors (SGLT2i) along with exogenous ketone body supplements have drawn much attention for their role in treating obesity and type 2 diabetes. Therefore, it is essential to clarify the effects of KBs on kidney diseases to understand the occurrence and development of kidney diseases correctly and guide clinical treatment. This review aims to summarize the current findings on the impact of ketone body metabolism, KDs, SGLT2i and exogenous ketone body supplements on kidney diseases.