Ricerc@Sapienza

Background: Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease. Very low-calorie ketogenic diets (VLCKD) represent a feasible treatment as they induce profound weight loss and insulin resistance (IR) improvement. Despite the recognized benefits on NAFLD deriving from pharmacological administration of fibroblast growth factor 21 (FGF21), whose endogenous counterpart is a marker of liver injury, little is known about its physiology in humans.

First identified as a feasible treatment for intractable epilepsy, the ketogenic diet
(KD) has recently gained popularity thanks to growing evidence on applications such
as weight loss, most importantly, but also NAFLD, cancer, neurologic conditions and
chronic pain. As with any treatment, whether pharmacologic or not, the KD might
not be an appropriate intervention for every individual, and a number of contraindications
have been proposed, now deeply rooted into clinical practice, excluding de

Very low-calorie ketogenic diets (VLCKD) are an effective and increasingly used tool for weight loss. Traditionally considered high protein, ketogenic diets are often looked at with concern by clinicians due to the potential harm they pose to kidney function. We herein evaluated the efficacy and safety of a VLCKD in patients with obesity and mild kidney failure. A prospective observational real-life study was conducted on ninety-two patients following a VLCKD for approximately 3 months.