Influence of Ramadan-type fasting on carbohydrate metabolism, brush border membrane enzymes and phosphate transport in rat kidney used as a model.

Ramadan fasting is a unique model of fasting in which Muslims the world over abstain from food and water from dawn to sunset for 1 month. We hypothesized that this model of prolonged intermittent fasting would result in specific adaptive alterations in rat kidney to keep a positive balance of metabolites and inorganic phosphate (Pi). The effect of Ramadan-type fasting was studied on enzymes of carbohydrate metabolism and brush border membrane (BBM) and BBM uptake of 32Pi in different renal tissue zones in the rat model. Rats were fasted (12 h) and then re-fed (12 h) daily for 30 d similar to human Ramadan fasting. Ramadan-type fasting resulted in increased serum Pi and phospholipids, whereas Pi clearance decreased. Serum creatinine and its clearance were not affected. Fasting caused a significant decrease in the activities of lactate and malate dehydrogenases, glucose-6-phosphatase and fructose-1,6-bisphosphatase, both in the renal cortex and medulla. However, the activity of glucose-6-phosphate dehydrogenase profoundly increased but that of malic enzyme decreased. The activities of alkaline phosphatase and gamma-glutamyl transpeptidase in BBM decreased, whereas transport of 32Pi significantly increased. The decrease in enzyme activities and increase in 32Pi transport were due to alterations of both maximal velocities and relative affinities. The results indicate that Ramadan-type fasting caused specific metabolic alterations with enhanced Pi conservation in different kidney tissues in a rat model used for Ramadan fasting in man.