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A small 12‐week study conducted on five patients with obesity and advanced diabetic nephropathy reported significant improvement in kidney function together with weight loss after a VLCKD intervention.11 Pointing in the same direction, five patients on haemodialysis underwent a low‐calorie, low carbohydrate diet for a median time of 364 days with no major safety concern and prominent weight loss.12 Guidelines are inconclusive on recommendations relative to protein intake in patients with CKD at early stages, with some suggesting .8 g/kg body weight,65 and others recommending up to 1.4 g/kg body weight.66 Renal function may be differentially affected by protein sources, with red meat proving potentially harmful in a dose dependent way, and other protein sources (fish, egg and dairies) being less noxious,67 with vegetable derived protein possibly even playing a protective role.68, 69 To avoid hepatic encephalopathy, it is suggested to privilege vegetable and dairy protein and decrease the amount of animal (meat) protein, with no reduction in total protein intake even when cirrhosis is present, unless directed by a health professional.62 However, with the prevalence of obesity increasing all over the world, and NAFLD being now a common cause of cirrhosis, over 30% of liver transplant recipients are obese, and weight loss is strongly encouraged.63 A case series reports that VLCKD treatment for obesity was well tolerated by two subjects with end stage liver disease (ESLD) effectively reducing weight with no adverse events, and possibly improving liver damage.8 But they are no substitute for disciplined diet, exercise, and medical planning when seeking significant or lasting weight loss. 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