Effects of fasting during the month of Ramadan on renal function in patients with autosomal dominant polycystic kidney disease .

BACKGROUND: In this study, we aimed to examine the impact of fasting during the month of Ramadan on autosomal dominant polycystic kidney disease (-ADPKD) patients with normal to near-normal glomerular filtration rate (GFR).

MATERIALS AND METHODS: This was a prospective observational study of patients with ADPKD, the majority of whom had normal or near-normal GFR. Patients were divided into two groups: the fasting group (FG) and the nonfasting group (NFG). Assessments in the NFG were performed 1 week before and 1 month after Ramadan, while FG patients were assessed on the last day of fasting in addition to the abovementioned visits. The following parameters were checked at each visit: blood pressure (BP), weight, sodium, potassium, blood urea nitrogen (BUN), creatinine, calcium, phosphorus, glucose, lipid profile, bicarbonate, urine density, 24-hour urine volume, 24-hour urine protein, GFR, neutrophil gelatinase-associated lipocalin (NGAL), and kidney injury molecule-1 (KIM-1). Kidney function tests were carried out on the 7^th day of fasting in the FG for the identification of early kidney damage.

RESULTS: Of the overall group of 54 patients, 23 were in FG (19 female) and 31 were in NFG (18 female). There were no significant differences between the two groups in terms of age, gender, ADPKD duration, and presence of hypertension. The mean estimated glomerular filtration rate (eGFR) values of FG and NFG were 86.4 ± 18.5 and 66.1 ± 36.5 mL/min/1.73m², respectively. During the follow-up period, no significant changes occurred in BP, weight, creatinine, 24-hour urine volume, NGAL, KIM-1, or GFR in either group (p > 0.05), while 24-hour urinary protein was significantly decreased in FG (p < 0.001).

CONCLUSION: A fasting duration of ~ 17 hours a day did not affect renal function negatively in patients with early-stage chronic kidney disease due to ADPKD. Also, no significant changes occurred in acute renal failure markers.
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