EFFECTS OF FASTING ON RENAL FUNCTION OF PATIENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE

Abstract

Introduction and Aims:Fasting means abstain from food and drink from sunrise to sunset in month of Ramadan and duration of the fasting ranges from 10 to 18 h per day (approximately17 h in this study). Fasting can be a possible risk factor for renal function impairment considering that dehydration is a well-known cause of kidney failure. In this study we aimed to evaluate this condition in autosomal dominant polycystic kidney disease (ADPKD) patients.Methods:This prospective observational study was conducted with 52 patients with ADPKD. Patients were divided into 2 groups according to fasting group (FG) and non-fasting group (NFG). The NFG were seen a week before Ramadan (BR) and a month after Ramadan (AR). The FG were seen the last day of the fasting (ER) in addition to the above visits. The following parameters were checked at each visit: Systolic blood pressure (SBP), diastolic blood pressure (DBP) weight, Na, K, creatinine, glucose, lipid profile, urine density, 24-hour urine volume, 24-hour urine protein and GFR. The urine samples were taken from each patient for neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in all visits. Kidney function tests were analyzed on the 5th day of fasting in FG for identify early kidney damage.Results:Of the remaining 52 patients there were 21 patients in FG and 31 patients in NFG. There was no significant difference between two groups in term of age, gender, disease duration and presence of hypertension (Table-1). During the follow-up period there was no significant change observed in SBP, DBP, weight, creatinine, albumin, lipid profile, urine density, 24-hour urine volume, NGAL, KIM-1 and GFR in both groups (Table-2). 24-hour urine protein was significantly decreased in FG.Conclusions:Fasting did not affect renal functions negatively in patients with early stages of chronic kidney disease due to ADPKD, besides it did not cause a significant change in markers of acute kidney injury. Daily urinary protein was significantly reduced in FG.