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Other concerns that are often raised but can be avoided by clinicians with a trained approach under dietitian-monitored MNT, include the following. Altogether, we believe that KMT can be consistent with different types of PLADO diets for the management of CKD and its different subtypes. Indeed, recent data suggest the association of higher fat intake, including saturated fat, with lower mortality . The PLADO diets are in contrast to the standard-of-care or traditional renal diets that often include 37]. Upcoming controlled clinical trials will evaluate long-term outcomes on metabolic and renal health. Even more remarkably, the beneficial effects of dietary KMT could largely be replicated by supplementing animals with BHB in the drinking water, which suggested that the effects may be due to BHB itself . Similarly, overweight status and obesity were shown to predict faster CKD progression in individuals with ADPKD . In contrast, the Mediterranean diet had no significant effects and led to a continuing decline in eGFR . SGLT2 inhibition also leads to elevation of blood ketone levels, which likely contributes to the benefit . Arguably, the same effect could be achieved by ingesting 80 g less sugar/starch per day, which is the equivalent to about two cans of soda. SGLT2 inhibition causes renal excretion of up to 80 g of glucose per day, thereby partially relieving the high carbohydrate burden from patients’ diets. In addition to serving as an energy source, BHB is also a signaling molecule that impacts multiple cellular pathways including its strong inhibition of the NLRP3 inflammasome leading to its potent anti-inflammatory properties. If hyperglycemia triggers CKD, it is a logical conclusion that hyperglycemia should be ameliorated as much as possible to prevent further renal health deterioration. In this review, we will not focus on discussing whether animal or plant foods are preferable for CKD, although there is emerging data on PLADO and PLAFOND diets [7, 8]. Biased investigators continue to publish in the scientific literature, which can create confusion for patients and clinicians who may not have time to extensively research each topic, relying on reviews to guide their evidence-based practice. This is perhaps because investigators themselves consume different types of foods and may wish to prove that their own dietary preferences are the optimal diet for the medical conditions of others, as seen in notorious opinion fights between vegans and carnivores. It is often mistakenly believed that the body has to ‘run on glucose’ or that the brain requires high blood glucose levels to function. In contrast, ketoacidosis occurs primarily in type 1 diabetes mellitus, is characterized by extremely high blood levels of both glucose and ketones and is a serious pathologic condition. 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