Metabolic Impacts of Ren-Nu: A Dietary Program for Polycystic Kidney Disease

Inclusion Criteria:

* Adult (18 years or older)

  * Diagnosis of ADPKD by a physician.
  * Estimated glomerular filtration rate (eGFR) ≥ 30 mL/min/1.73 m2 at screening using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation.
  * Appropriate control of blood pressure (i.e. entry reading \<140/90) including the use of BP medications for diagnosis of hypertension.
  * BMI ≥ 25 (accounting for muscle mass)
  * Own an at-home blood pressure monitor (no brand requirements)
  * Able to complete study-related activities (e.g., attend online classes, complete questionnaires, and proper use of medical devices)

Exclusion Criteria:

* Intolerance or allergy to any of the ingredients in the provided medical food

  * Severe or rare underlying health conditions may cause a safety risk when taking the medical food. Those underlying health conditions will be assessed by the enrolling physician and include but are not limited to:

    * History of hyperkalemia
    * Heart failure
    * Liver cirrhosis
    * Chronic kidney disease stage 4 or greater, or other renal condition that severely impairs bone mineral homeostasis.
    * HIV infection
    * Chronic drug or alcohol abuse
    * Chronic malabsorption syndrome
    * Malignancy (non-melanoma skin cancer exempted)
    * Autoimmune disease
    * Pregnant, planning to be pregnant, or nursing during the course of the study
    * Chronic history of recurrent urinary tract infections (UTI) (≥ 3 UTIs per year)
    * Diagnosis of aneurysm
    * Indigestion due to hypochlorhydria (low stomach acid)
    * Any other condition, that in the opinion of the enrolling physician, makes the subject an unsuitable candidate for the study.
  * Current use of any of the following medications or supplements which could affect safety or compliance with this study:

    * The medical food, KetoCitra®.
    * Urine alkalizing agents such as sodium bicarbonate or potassium citrate
    * Citrate treatments
    * Immunosuppressive treatment
    * Tolvaptan
    * Potassium-sparing diuretics
    * Somatostatin analogs
    * Aluminum-containing supplements or medications such as aluminum antacids (e.g. Maalox) or aluminum-based phosphate binders.
    * SGLT2 inhibitors
  * Participation in another therapeutic intervention trial.
  * Following a highly specialized or extreme diet that is incompatible with the interventional nutrition program (e.g. carnivore, very high protein diet for elite athletes, etc.)
  * Food sensitivities or allergies that are incompatible with the interventional nutrition program.
  * The subject is already adhering to a form of a ketogenic diet or related fasting regimen.
  * Current or past history of disordered eating or feeding behaviors.
  * History of gastric bypass.
  * Active diagnosis of ulcerative colitis, Irritable Bowel Syndrome, Crohn's, or Gallbladder Disease.