Serum ketone body levels and risk of incident kidney and cardiovascular events among patients with type 2 diabetes: a prospective cohort study
Authors' conclusion
Mildly elevated serum ketone body levels were independently associated with lower adverse kidney outcomes in patients with type 2 diabetes
Study context
- Population
- Clinically stable patients with T2D not receiving insulin or TZD therapy; serum total ketone bodies measured under stable outpatient conditions
- Participants
- 1,392 patients
- Exposure
- Highest vs lowest serum total ketone body tertile
- Outcome
- Kidney outcomes (new-onset macroalbuminuria, ≥40% eGFR decline, end-stage kidney disease) and CV outcomes (MI, revascularization, ischemic stroke, hospitalization for HF, CV death)
- Follow-up
- median 23.2-month follow-up
Main finding
As reported in the abstract
Kidney outcomes
Highest tertile vs Lowest tertileAdjusted hazard ratio (95% CI)
≥40% eGFR decline
0.46(0.26–0.84)
Composite kidney outcomes
0.63(0.41–0.98)
- Kidney events
- 158
Observational data: associations, not effects.
Further findings
Incident CKD, subgroup with baseline eGFR ≥ 60 mL/min/1.73 m²
- Incident CKD also reduced (aHR)
- 0.50
- 95%CI
- 0.31-0.79
Cardiovascular outcomes
- Cardiovascular outcomes showed favorable but non-significant trends
Original publication
Serum ketone body levels and risk of incident kidney and cardiovascular events among patients with type 2 diabetes: a prospective cohort study. Diabetes Res Clin Pract. Published 31 July 2026. doi:10.
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