HMGCS2 and diabetic kidney disease: SGLT2 inhibitors improved renal impairment accompanied by an increase in blood ketone body levels in HFD-fed Apo E-deficient mice.9 However, this renoprotective effect of SGLT2 inhibitors was abolished in mice lacking the rate-limiting enzyme for endogenous ketone production, HMGCS2.9 Thus, the increase in blood ketone levels contributes to one of the mechanisms of renoprotection by SGLT2 inhibitors in DKD.