Effect of Ramadan Fasting on Chronic Inflammation and Body Composition in Patients with Chronic Kidney Disease

Chronic kidney disease (CKD) is associated with a state of chronic inflammation which is responsible for many of the pathophysiological changes detected in these patients. Many studies have evaluated the effect of Ramadan fasting on renal function and cardiovascular morbidity in CKD patients, but the effect of Ramadan fasting on markers of chronic inflammation was not previously assessed. This study aimed to evaluate the effect of Ramadan fasting on some markers of chronic inflammation in CKD patients with estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m² body surface area and not on dialysis. This was a pilot study that included 20 patients (8 males and 12 females), mean age 61.9 years with CKD (eGFR <60 mL/min/1.73 m² body surface area not on dialysis) who fasted the whole lunar month of Ramadan. Complete blood count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), high-sensitive C-reactive protein (hs-CRP), serum creatinine (SCr), eGFR, serum albumin, body weight, body mass index (BMI), and body composition assessed by bioimpedance analysis were assessed before and after Ramadan fasting. Ramadan fasting was not associated with significant change of SCr (P = 0.132), eGFR (P = 0.097), serum albumin (P = 0.352), body weight (P = 0.445), BMI (P = 0.168), body fat (P = 0.979), visceral fat (P = 0.163), muscle mass (P = 0.662), or body water (P = 0.815). There was a statistically significant decrease of markers of chronic inflammation including NLR (P = 0.003), PLR (P = 0.005), and hs-CRP (P = 0.000) after Ramadan fasting. Ramadan fasting was associated with improvement of the state of chronic inflammation in CKD patients (eGFR below 60 mL/min/1.73 m² body surface area). Ramadan fasting was not associated with a significant change of body composition or deterioration of renal function tests in CKD patients.