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VMAX Male Enhancement Claims: A recent 2-year study on almost 200 individuals with T2D and following a ketogenic diet versus 68 controls on usual care showed no increased CVD risk, and in most cases improved lipids, including the LDL particle profiles . The only lipid marker that is consistently reported to be elevated in some individuals on ketogenic diets is LDL-C. Serum lipid levels and their impact on cardiovascular disease (CVD) risk in a state of ketosis is a controversial topic due to the fact that lipid levels and CVD have primarily been studied in a glucose-fed state. However, interestingly, ≈50% of the kidney stones in subjects on ketogenic diets were uric acid stones and an additional 28% were mixed uric acid and calcium stones , suggesting a potential link to animal protein intake as a known cause of high uric acid burden. A recent meta-analysis estimated that ≈8% of individuals on ketogenic diets develop kidney stones during a follow-up of ≈4 years . Furthermore, the ketogenic diet group showed a trend towards a reduction of kidney volume while not reaching statistical significance. A randomized, prospective pilot trial (KETO-ADPKD) was recently completed in which 66 ADPKD patients were randomized to either of two KMT arms (periodic water fasting or ketogenic diet) or a control group for a 3-month intervention . While ketone levels were, unfortunately, not measured in this study, it must be assumed that those subjects who achieved the greatest weight loss would have had the highest ketone levels during the study. Unexpectedly, ketogenic diets even led to disease reversal in a rat model, which was previously thought to be impossible . On mouse, rat and cat models of ADPKD showed that KMT interventions—time-restricted feeding, acute fasting, ketogenic diet—all led to dramatic slowing of CKD progression [24, 33]. A recent study compared intervention with a ketogenic diet via continuous remote telemedicine care in 262 individuals with T2D and an eGFR 2 with 87 matched individuals receiving usual care over 2 years . In a baseline-controlled, real-life observational prospective study, 92 obese participants were subjected to a ketogenic diet for 15 weeks, including 38 subjects with mild CKD (stage 2) . The ketogenic diet generally had the greatest beneficial effect on renal function, especially in participants with CKD stage 3 [estimated glomerular filtration rate (eGFR) improvement by 7.1 points over 2 years] . Because protein restriction has traditionally been central to most dietary guidelines for CKD management, it is important to note that many of these studies used a higher protein approach along with ketosis and still saw benefits. Work (by T.W.) showed that intermittent fasting, acute fasting, ketogenic diet or supplementation with BHB resulted in cessation of the progression of CKD in mouse, rat and cat models of polycystic kidney disease and even led to reversal of established CKD . For example, diabetic nephropathy in mouse models of type 1 and type 2 diabetes was completely reversed by 2-months of maintenance on a ketogenic diet . As mentioned above, BHB has potent anti-inflammatory properties, and ketogenic diets have been shown to reduce low-grade inflammation in obesity and other conditions . For example, criticism of ketogenic diets—wrongfully perceived as animal-based diets—often comes from organizations devoted to the prevention of animal cruelty and the promotion of plant-based diets, which is understandable but not scientifically sound. Nevertheless, this and similar uninformed press releases are often reflected in the lay press and touted as proof that ketogenic diets are harmful. 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