Ketone monoester supplementation causes acute increases in glomerular filtration rate and alterations in sodium and potassium excretion, but these effects are not sustained over a 24-hour period, as total daily urinary electrolyte excretion remains unchanged.

When ketones enter the blood, they cause the kidney's filtering units to take in more blood and filter it faster, while also reducing how much salt the kidney reabsorbs and how much potassium it lets out. The body responds by releasing hormones that try to pull salt back in, but this response is too slow and weak to fully reverse the initial changes. By the end of the day, the total amount of salt and potassium lost in urine returns to normal because the body balances the early losses with later recovery.