Impact of Ramadan fasting on eGFR in patients with late stage chronic kidney disease

Aims: Ramadan fasting is a significant religious practice observed annually by approximately 1.9 billion adult Muslims worldwide. However, its potential impact on kidney health in individuals with chronic kidney disease (CKD) remains a subject of concern. This study aimed to investigate the effects of Ramadan fasting on renal function in patients with stage 3-5 CKD and to identify any associated risk factors. Methods: A single-center, self-controlled longitudinal observational study was conducted on 192 stable patients with stage 3-5 CKD who observed Ramadan fasting. The fasting period was about 14-15 hours per day for one month Various clinical parameters, including eGFR, blood urea nitrogen (BUN), sodium (Na+), potassium (K+), calcium (Ca++), phosphorus, parathyroid hormone (PTH), albumin, uric acid, fasting glucose, total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and hemoglobin (Hgb), were measured before and after Ramadan fasting. P<0.05 was assumed significant. Results: The study results demonstrated no significant deterioration in eGFR during Ramadan fasting (pre-Ramadan: 43.54±11.04 vs post-Ramadan: 44.28±11.51, p=0.063). Additionally, traditional risk factors for CKD progression, such as diabetes mellitus (DM), hypertension (HT), cardiovascular disease CVD, and age, did not show a significant association with eGFR changes during fasting (p>0.05). Furthermore, the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) did not impact eGFR (0.084). Notably, Ramadan fasting led to improvements in metabolic parameters, such as fasting glucose and lipid profile, except for triglyceride levels (p<0.001). Conclusion: The study results indicate that Ramadan fasting does not appear to have adverse effects on kidney function in individuals with CKD, although certain metabolic changes were observed.

Keywords:

Ramadan fasting, chronic kidney disease, glomerular filtration rate, metabolic parameters kidney function,

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