This article discusses the potential benefits of ketone bodies in promoting kidney health and preventing various kidney diseases. Ketones serve important energetic roles in the kidney and contribute to maintaining ketone homeostasis through renal tubular reabsorption. The mechanisms involve regulating gene expression and modulating several signal transduction pathways that lead to oxidative stress reduction, suppression of inflammation, prevention of interstitial fibrosis development, and protection of renal cells from apoptosis and pyroptosis.