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On the other hand, kidney stones, decreased bone mineralisation, and changes in blood electrolyte levels might all be long-term consequences of chronic acidosis [123,124]. In addition to direct interactions as a result of the ketosis state, the administration of general anaesthetics, such as sevoflurane, in patients undergoing the KD determines possible implications for anaesthetic depth, pharmacokinetics, and recovery dynamics. Anxiolytics and hypnotic agents are metabolised in the liver, which means that diet-induced changes in CYP P450 activity could theoretically affect their metabolism and elimination from the body. Compared to the control and control groups, an enhanced therapeutic effect and greater safety were demonstrated when olanzapine was administered to mice in the ketosis state . However, their effectiveness is often limited, with a substantial proportion of patients experiencing only partial relief of symptoms or significant side effects such as weight gain, metabolic disorders, and extrapyramidal symptoms. It has been hypothesised that the drop in INRs could be caused by an increase in levels of serum albumin as well as cytochrome P450 activity, which could be achieved by increasing dietary protein intake. Hence, similar to beta-blockers, it is imperative to note that rigorous monitoring is required when administering thiazide diuretics to patients on a KD, as their pharmacodynamics have the potential to disrupt the ketogenic state. Beta-blockers and exercise are both involved in mediating ketosis, with beta-blockers playing a more significant role than exercise. This study investigates the effect of the low-protein diet supplemented with ketoacids (LPD+KA) on the RAAS in chronic kidney disease. 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