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Kovesdy received consulting fees from Abbott, Akebia, Ardelyx, Astra Zeneca, Bayer, Boehringer Ingelheim, Cara Therapeutics, CSL Behring, CSL Vifor, GSK, Pharmacosmos, ProKidney, Renibus and Takeda

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D-lactate is a secondary byproduct of the glyoxylate pathway and gut microbial metabolism, lacking mitochondrial oxidizing capacity in the central nervous system and undergoing non-enzymatic D-lactylation solely mediated by lactylglutathione (Xin et al., 2022