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Preclinical approaches to reduce hepatotoxicity include nanoparticle encapsulation with hepatocyte-avoidant peptides, which reduce liver uptake by up to 90%, or co-administration with PPAR agonists to enhance lipid clearance [228]

QuCKeijerJAdjobo-HermansMJWvan de WalMSchirrisTvan KarnebeekCet alThe ketogenic diet as a therapeutic intervention strategy in mitochondrial disease

Contraindications Pregnancy and lactation: individual case reports suggest safety during pregnancy (de Bruyn 2015), however data which mainly include in vivo studies (Xi 2008) are insufficient

Several studies have been reported that emphasize the oxidative and inflammatory stress progressively associated with sustained focal segmental glomerulosclerosis