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Obesity and diabetes are major risk factors for kidney disease, and obese patients with chronic kidney disease (CKD) are potential candidates for weight reducing diets, among them\u00a0ketogenic diets. Of further relevance to nephrology, a limited number of recent studies suggests a favorable effect of ketogenic diets in patients affected by\u00a0autosomal dominant polycystic kidney disease (ADPKD). However, concerns remain about safety in patients with CKD, particularly in the long term and in those with poor residual kidney function. The confusion surrounding the definition of ketogenic diets adds to these concerns. The aim of this review is to summarize information on the main types of ketogenic diets used in daily practice and to discuss the options for their implementation in CKD patients, limiting ultra-processed or industrial preparations.<\/jats:p>\n                  <jats:p>Although further studies are needed to identify the profile of CKD patients who may benefit from the implementation of ketogenic diets to treat obesity or slow the progression of ADPKD, and to assess short- and long-term safety and adherence, the available data appear promising. This critical review is intended to stimulate further research.<\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s40620-025-02285-7","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T07:35:00Z","timestamp":1746171300000},"page":"1541-1556","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ketogenic diets in chronic kidney disease patients: a review for skeptics by skeptics"],"prefix":"10.1093","volume":"38","author":[{"given":"Claudia","family":"D\u2019Alessandro","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Giannese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgina Barbara","family":"Piccoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Panichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-936X","authenticated-orcid":false,"given":"Adamasco","family":"Cupisti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"2285_CR1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.plefa.2003.11.001","volume":"70","author":"T Fukao","year":"2004","unstructured":"Fukao T, Lopaschuk GD, Mitchel GA (2004) Pathways and control of ketone body metabolism: on the fringe of lipid biochemistry. 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