Renal effects of short-term ketone monoester supplementation in healthy adults: A randomized, placebo-controlled study.
Level 2 - randomized trial
Double-blind, randomized, placebo-controlled crossover trial
PubMed 41839727 · doi:10.14814/phy2.70829
What was done
A double-blind, placebo-controlled, randomized crossover trial evaluated the renal effects of short-term exogenous ketosis in 15 healthy adults (13 completed both arms). Participants received either ketone monoester (KME) or placebo three times daily for 5 days under a standardized diet, separated by a 2-week washout. On day 5, a 24-hour urine sample was collected. On day 6, glomerular filtration rate (GFR) was assessed via 99mTc-DTPA clearance alongside urinary electrolyte excretion measurements.
What was found
Compared with placebo, KME acutely increased GFR by 6.0 mL/min (p = 0.002) and increased sodium excretion by 69 μmol/min (p < 0.0001), while potassium excretion decreased by 31 μmol/min (-31 μmol/min; p < 0.0001). Total electrolyte excretion measured in 24-hour urine remained unchanged.
Why it matters
Exogenous ketone supplements are increasingly used for metabolic and athletic applications, but their renal impact has been unclear. This study provides direct physiological evidence that KME transiently alters glomerular filtration and acute electrolyte handling in healthy adults.
Limits
The sample size is very small (13 completed). The study only assessed short-term (5-day) exposure in healthy adults, leaving long-term renal safety and effects in individuals with kidney disease or hypertension unexamined.
Cited by
- context The state of ketosis promotes the depletion of electrolytes from the body.