Effect of Ramadan Fasting on Malondialdehyde, Poly (ADPRibose) Polymerase, Sirtuin 1, Nuclear Receptor Subfamily 1 Group D Member 1, and Transforming Growth Factor Beta in Chronic Kidney Disease: A Prospective Cohort Study

Abstract

Background: Chronic kidney disease (CKD) is a global health problem with increasing prevalence. This study aims to analyze the effect of Ramadan fasting on important biomarkers in CKD patients. Methods: A prospective cohort study was conducted on 30 CKD patients with stages 1, 2, and 3A who underwent Ramadan fasting. Measurements of MDA, PARP, SIRT1, NR1D1, and TGF-β levels were carried out before fasting, 2 weeks during fasting, and after fasting using the Enzyme-linked immunosorbent assay (ELISA) method. Results: There were significant decreases in urea, fasting blood glucose, HbA1C, and uric acid levels (p<0.05). MDA and SIRT1 decreased significantly (p<0.001), while PARP and NR1D1 increased significantly (p<0.001). TGF-β also showed a decrease. There were no significant changes in lipid profiles, creatinine, and albumin. Conclusion: Ramadan fasting has significant effects on several biochemical parameters and biological markers in early-stage CKD patients. These changes indicate potential improvements in oxidative stress, cell autophagy, inflammation regulation, and circadian rhythm. Further studies are needed to evaluate the long-term effects and clinical implications of these findings in CKD management.