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Boobes Y, Afandi B, AlKindi F, Tarakji A, Al Ghamdi SM, Alrukhaimi M, Hassanein M, AlSahow A, Said R, Alsaid J, Alsuwaida AO, Al Obaidli AAK, Alketbi LB, Boubes K, Attallah N, Al Salmi IS, Abdelhamid YM, Bashir NM, Aburahma RMY, Hassan MH, Al-Hakim MR. Consensus recommendations on fasting during Ramadan for patients with kidney disease: review of available evidence and a call for action (RaK Initiative). BMC Nephrol 2024; 25:84. [PMID: 38448807 PMCID: PMC10916266 DOI: 10.1186/s12882-024-03516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024] Open
Abstract
Ramadan fasting (RF) involves abstaining from food and drink during daylight hours; it is obligatory for all healthy Muslims from the age of puberty. Although sick individuals are exempt from fasting, many will fast anyway. This article explores the impact of RF on individuals with kidney diseases through a comprehensive review of existing literature and consensus recommendations. This study was conducted by a multidisciplinary panel of experts.The recommendations aim to provide a structured approach to assess and manage fasting during Ramadan for patients with kidney diseases, empowering both healthcare providers and patients to make informed decisions while considering their unique circumstances.
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Affiliation(s)
- Yousef Boobes
- Seha Kidney Care, Tawam Hospital, Al Ain, UAE.
- Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE.
| | - Bachar Afandi
- Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE
- Endocrine Division, Tawam Hospital, Al Ain, UAE
| | | | - Ahmad Tarakji
- St. George Medical Center & McMaster University-Waterloo Campus, Kitchener, ON, Canada
| | | | | | - Mohamed Hassanein
- Endocrine Section, Dubai Hospital, Dubai Health, Dubai, UAE
- Mohammed Bin Rashid University of Medicine and Health Science, Dubai, UAE
| | - Ali AlSahow
- Division of Nephrology, Jahra Hospital, Jahra, Kuwait
| | - Riyad Said
- Department of Nephrology and Medicine, Jordan Hospital and Medical Center Ibn Sina University for Medical Sciences, Amman, Jordan
| | - Jafar Alsaid
- Nephrology department, Ochsner Medical Center, New Orleans, LA, USA
| | | | | | - Latifa B Alketbi
- Ambulatory Healthcare Services - Abu Dhabi Healthcare Services, Abu Dhabi, UAE
| | - Khaled Boubes
- Department of Medicine, Ohio State University, Columbus, OH, USA
| | - Nizar Attallah
- Nephrology Associates of Kentuckiana, University of Kentucky, Louisville, USA
| | - Issa S Al Salmi
- Department of Renal Medicine, The Royal Hospital, Muscat, Oman
| | - Yasser M Abdelhamid
- Nephrology Division, Internal Medicine Department -Faculty of Medicine, Cairo University, Cairo, Egypt
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AlSahow A. The Impact of Hot Ambient Temperature and Prolonged Fasting Duration during Ramadan on Patients with Chronic Kidney Disease: A Literature Review. Int J Nephrol 2023; 2023:2636507. [PMID: 38106546 PMCID: PMC10725313 DOI: 10.1155/2023/2636507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023] Open
Abstract
The Islamic (lunar) calendar has 11 fewer days each year than the Gregorian (solar) calendar. Consequently, ambient temperatures during the month of Ramadan and the duration of the presunrise-to-sunset fast will change each year. At some point, individuals observing Ramadan will experience prolonged periods of fasting during the hot summer months. In this manuscript, findings published in the English-language medical literature that address the impact of prolonged fasting during the warmer summer months on patients with chronic kidney disease, including dialysis and transplantation patients, are reviewed. This is of particular concern given the accelerated pace of global warming. The limitations of the evidence that is currently available are also discussed, and an approach that might be used to standardize future evaluations of the impact of fasting on kidney health is suggested.
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Affiliation(s)
- Ali AlSahow
- Division of Nephrology, Jahra Hospital, Jahra, Kuwait
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Habas E, Errayes M, Habas E, Farfar KL, Alfitori G, Habas AE, Rayani A, Elzouki ANY. Fasting Ramadan in Chronic Kidney Disease (CKD), Kidney Transplant and Dialysis Patients: Review and Update. Cureus 2022; 14:e25269. [PMID: 35755525 PMCID: PMC9218841 DOI: 10.7759/cureus.25269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/12/2022] Open
Abstract
Chronic kidney disease (CKD) is a common disease in the Islamic regions. Dehydration occurs after prolonged fasting, particularly in hot and humid climates. In the Arabic months’ calendar, Ramadan is a month of maximum given deeds, where Muslims are required to fast from dawn till sunset. Depending on where you live and when the Ramadan month falls, fasting might last anywhere from 10 to 20 hours or more. In certain circumstances, such as poorly controlled diabetes and advanced CKD patients who are allowed to break their fast, the Ramadan fasting amendment is viable. Some Muslims, however, continue fasting despite these circumstances, placing themselves at risk, which is not allowed in the Islamic religion. There are no medical recommendations that specify who should and should not fast. Nonetheless, the recommendations have been extracted from several published studies. The authors searched EMBASE, PubMed, Google Scholar, and Google for publications, research, and reviews. All authors debate and analyze the related articles. Each author was assigned a part or two of the topics to read, study, and summarize before creating the final draft of their given section. Then this comprehensive review was completed after discussion sessions. In conclusion, by the Islamic religion view, fasting Ramadan is mandatory for every wise adult person. People who have chronic diseases or that may deteriorate by fasting are exempted from fasting. It seems that fasting and the associated disease hours are determinant factors to fasting or not fasting. Up to our knowledge, there are no established guidelines for CKD patients and physicians to follow; however, the International Diabetes Federation and Diabetes and Ramadan (IDF-DAR) Practical Guidelines 2021 have been issued for CKD diabetic patients and fasting.
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Binsalih S, Al Sayyari RA, Sheikho M, Hejaili FF, Al Sayyari AA. Effect of Fasting the Whole Month of Ramadan on Renal Function Among Muslim Patients With Kidney Transplant: A Meta-Analysis. EXP CLIN TRANSPLANT 2020; 17:588-593. [PMID: 31570092 DOI: 10.6002/ect.2019.0245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Muslim renal transplant patients often ask whether fasting during Ramadan would be harmful to their kidneys. We performed a meta-analysis on relevant studies to answer this question. MATERIALS AND METHODS We searched 4 databases using comprehensive search terms with predefined eligibility criteria. Two reviewers (FH and RA) independently assessed the relevance of studies obtained during the search. If disagreement occurred, a consensus would be sought; if disagreement persisted, the arbitration would be left to a third author (AAS). RESULTS Eight studies (549 patients) were identified as eligible; these studies measured renal function before and after Ramadan with patients acting as their own controls in 5 studies. Our pooled analyses showed no significant changes after fasting with regard to estimated glomerular filtration rate (70.1 ± 9.1 vs 68.5 ± 7.5 mL/min, respectively; P = .6) or in serum creatinine levels (105.3 ± 8.8 and 106.1 ± 6.0 μmol/L, respectively; P = .47). In 4 self-controlled studies (148 patients) that had analyzed changes in systolic and diastolic blood pressure before versus after fasting, no significant differences were shown. However, in 3 studies that assessed changes in glomerular filtration rate in fasting (n = 358) versus nonfasting patients (n = 355), there was a significant difference in change in glomerular filtration rate following Ramadan fasting (-0.13 ± 1.2 mL/min in those who fasted versus 4.2 ± 4.6 mL/min in those who did not fast; P = .039); however, these results were associated with significant publication bias (systematic heterogeneity). CONCLUSIONS Fasting during Ramadan did not result in significant changes in kidney function or blood pressure in posttransplant patients with good baseline kidney function when patients acted as their own controls.
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Affiliation(s)
- Salih Binsalih
- From the King Saudi Bin Abdulaziz University for Heath Sciences, Riyadh, Kingdom of Saudi Arabia
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Ahmad S, Chowdhury TA. Fasting during Ramadan in people with chronic kidney disease: a review of the literature. Ther Adv Endocrinol Metab 2019; 10:2042018819889019. [PMID: 31798822 PMCID: PMC6859673 DOI: 10.1177/2042018819889019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/27/2019] [Indexed: 12/18/2022] Open
Abstract
Chronic kidney disease (CKD) is common among Muslim patients, and many such patients are keen to fast during the month of Ramadan. Fasting for prolonged periods may be deleterious for patients with CKD, but the changing season of fasting means that the duration of fast is very variable between geographical locations. There is, furthermore, a paucity of evidence to guide patients and clinicians in management of fasting in people with CKD. In this article, we aim to review the available evidence for patients with CKD and fasting, including haemodialysis and renal transplantation. We suggest that all patients with CKD should be deemed high risk or very high risk for fasting. We conclude, however, that patients with stable mild/moderate CKD (stage 1-3) may be able to fast providing they are carefully monitored and counselled. We also suggest that patients with stable renal transplants may also be able to fast, providing they are monitored carefully by their transplant team. Patients on haemodialysis or peritoneal dialysis should not be encouraged to fast, but if they do so, they will need careful weekly monitoring. There is an urgent need for high-quality data for patients with CKD who plan to fast over Ramadan, to enable more guidance to be developed for this vulnerable group of patients.
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Affiliation(s)
- Shahzaib Ahmad
- Specialist Trainee in Anaesthetics and Intensive Care, Department of Anaesthetics and Intensive Care, St Helier Hospital, London, UK
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Ramadan Fasting in Kidney Transplant Recipients: A Single-Centre Retrospective Study. J Transplant 2018; 2018:4890978. [PMID: 29973984 PMCID: PMC6008647 DOI: 10.1155/2018/4890978] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/05/2018] [Indexed: 11/17/2022] Open
Abstract
Background Fasting during the lunar month of Ramadan is mandatory to all healthy adult Muslims. Renal transplant recipients are often worried about the impact of fluid and electrolyte deprivation during fasting on the function of their allograft. We aimed to examine the effect of fasting Ramadan on the graft function in renal transplant recipients. Methods This retrospective cohort study included patients who underwent kidney transplantation in our tertiary referral center. Baseline pre-Ramadan estimated glomerular filtration rate (eGFR), mean arterial pressure (MAP), and urinary protein excretion were compared to those during and after Ramadan within and between the fasting and non-fasting groups. Results The study population included 280 kidney transplant recipients who chose to fast during the Ramadan month (June-July 2014) and 285 recipients who did not fast. In the fasting group, baseline eGFR did not change from that during or post-Ramadan (72.6 ± 23.7 versus 72.3 ± 24.5 mL/min/1.73 m2, P = 0.53; and 72.6 ± 23.7 versus 72 ± 23.2 mL/min/1.73 m2, P = 0.14, respectively). Compared to baseline, there were no significant differences between the fasting and the non-fasting groups in terms of mean percent changes in eGFR, MAP, and urinary protein excretion. Conclusion Fasting during the month of Ramadan did not have significant adverse effects on renal allograft function.
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Hassan S, Hassan F, Abbas N, Hassan K, Khatib N, Edgim R, Fadol R, Khazim K. Does Ramadan Fasting Affect Hydration Status and Kidney Function in CKD Patients? ANNALS OF NUTRITION AND METABOLISM 2018. [PMID: 29518785 DOI: 10.1159/000486799] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS This study is the first of its kind to examine the impact of the Ramadan fasting on hydration status, plasma brain natriuretic peptide (BNP) levels, and kidney function in chronic kidney disease (CKD) patient. METHODS This prospective cohort study included 2 groups of patients with CKD grades 2-4: thirty-one Muslim patients who fasted the month of Ramadan (fasting group) and 26 Muslim patients who did not fast (control group). One week before the Ramadan fast, in the last week of the month of Ramadan (4 weeks), and 4 weeks after the end of the Ramadan month (8 weeks), hydration status and blood analysis of urea, creatinine and BNP levels were measured. RESULTS Among fasting patients, serum urea levels increased significantly (p = 0.024) during the last week of fasting and returned to basal levels at 4 weeks after the end of the Ramadan month, the estimated glomerular filtration rate did not change significantly at the end of fasting (p = 0.411), the hydration status indices and plasma BNP levels were significantly decreased after fasting (p ≤ 0.021) but returned to basal values 4 weeks thereafter. CONCLUSIONS Patients with CKD grades 2-4 can fast throughout the month of Ramadan with no significant deterioration of renal functions and with a reasonable degree of safety.
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Affiliation(s)
- Shadia Hassan
- Department of Pediatric, Galilee Medical Center, Nahariya, Israel
| | - Fadi Hassan
- Department of Internal Medicine E, Galilee Medical Center, Nahariya, Israel
| | - Nur Abbas
- Clalit Health Services, Haifa and Western Galilee, Haifa, Israel
| | - Kamal Hassan
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Nihal Khatib
- Clalit Health Services, Haifa and Western Galilee, Haifa, Israel
| | - Rabia Edgim
- Department of Nephrology and Hypertension, Galilee Medical Center, Nahariya, Israel
| | - Rawia Fadol
- Department of Nephrology and Hypertension, Galilee Medical Center, Nahariya, Israel
| | - Khaled Khazim
- Department of Nephrology and Hypertension, Galilee Medical Center, Nahariya, Israel
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Bragazzi NL. Ramadan fasting and chronic kidney disease: does estimated glomerular filtration rate change after and before Ramadan? Insights from a mini meta-analysis. Int J Nephrol Renovasc Dis 2015; 8:53-7. [PMID: 26082658 PMCID: PMC4459622 DOI: 10.2147/ijnrd.s61718] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ramadan fasting represents one of the five pillars of the Islam creed. Even though patients are exempted from this religious duty, they may be eager to share this particular moment of the year with their family and peers, taking part in the intense spiritual ceremonies and events that characterize this month. However, there are no guidelines or standardized protocols that can help physicians to properly address the issue of patients with chronic kidney disease fasting in Ramadan and correctly advising them. For this purpose, we carried out a systematic review and a meta-analysis to see whether glomerular filtration rate value changed before and after Ramadan. Our main findings are that: chronic kidney disease patients can safely fast during Ramadan since glomerular filtration rate does not change in a statistically significant way and, even though most studies have been carried out during Ramadan falling in cold seasons, the sensitivity analysis did not reveal any impact of seasonality. Further research in the field is needed.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy ; Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy ; Università Islamica d'Italia, Lecce, Italy
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Bayoglu Tekin Y, Guvendag Guven ES, Mete Ural U, Yazici ZA, Kirbas A, Kir Sahin F. Evaluation of the effects of fasting associated dehydration on maternal NGAL levels and fetal renal artery Doppler parameters. J Matern Fetal Neonatal Med 2015; 29:629-32. [DOI: 10.3109/14767058.2015.1014789] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | | | | | | | - Aynur Kirbas
- Department of Biochemistry, Recep Tayyip Erdogan University, School of Medicine, Rize, Turkey
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Hejaili F, Qurashi S, Binsalih S, Jaradt M, Al Sayyari A. Effect of repeated ramadan fasting in the hottest months of the year on renal graft function. Nephrourol Mon 2014; 6:e14362. [PMID: 24719821 PMCID: PMC3968970 DOI: 10.5812/numonthly.14362] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 09/07/2013] [Accepted: 09/29/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adult Moslems are required to fast during the lunar month of Ramadan every year. Although the sick and travelers, as well as some other specified groups, are exempted from this requirement. OBJECTIVES To investigate the effect of repeated Ramadan fasting during the hottest months of the year on renal graft functions. PATIENTS AND METHODS This was a prospective cohort study comparing two groups of renal transplant receivers; one group had fasted for two consecutive Ramadan months during 2011 and 2012, while the other group had not fasted. The baseline eGFR (estimated glomerular filtration rate) was compared to the eGFR carried out 19.6 ± 1.3 months later, within and between groups. Further subgroup analysis was done according to eGFR baseline; low (< 45 mL/min/1.73 m(2)), moderate 45-75 (mL/min/1.73 m(2)), and high (> 75 mL/min/1.73 m(2)). RESULTS There were 43 fasting and 37 non-fasting participants with comparable; ages, gender, type of transplant, and baseline eGFR and serum creatinine (SCr). The fasting participants, however, had a longer elapsed time since their transplantation. In the fasting group, SCr and eGFR did not change from baseline after a mean follow-up period of 19.6 ± 1.3 months; SCr of 105.1 ± 55.4 and 114.2 ± 71.5 µmol/L, respectively (P-value = 0.8), and eGFR 75.6 ± 29.2 and 70.2 ± 28.1 mL/min/1.73 m(2), respectively (P-value = 0.09). Similarly, no significant changes were observed in the non-fasting group; Sr of 123.1 ± 67 and 115.8 ± 65.2 µmol/L, respectively (P-value = 0.6), and eGFR of 65.9 ± 25.9 and 68.8 ± 24.6 mL/min/1.73 m(2), respectively (P-value = 0.6). On subgroup analysis, according to the eGFR level, we found no significant differences in the eGFR, before and after 19.6 ± 1.3 months, in the severe and moderate subgroups. However, a significant but similar drop was noted in the high GFR subgroups in both the fasting subgroup (96.4 ± 15 to 84.9 ± 20.7 mL/min/1.73 m(2); P = 0.17) and in the non-fasting subgroup (92.9 ± 15.8 to 82.3 ± 18.2 mL/min/1.73 m(2); P = 0.019). CONCLUSIONS Fasting in the month of Ramadan in two consecutive years, and during the hottest months, in Riyadh, Saudi Arabia, did not adversely affect kidney graft function.
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Affiliation(s)
- Fayez Hejaili
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salim Qurashi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salih Binsalih
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Maha Jaradt
- King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulla Al Sayyari
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Corresponding author: Abdulla Al Sayyari, King Saud Bin Abdulaziz University for Health Sciences, P.O.Box: 22490, Riyadh, Saudi Arabia. Tel: +966-12520088, E-mail:
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Al Wakeel J, Mitwalli AH, Alsuwaida A, Al Ghonaim M, Usama S, Hayat A, Shah IH. Recommendations for fasting in Ramadan for patients on peritoneal dialysis. Perit Dial Int 2013; 33:86-91. [PMID: 23349195 DOI: 10.3747/pdi.2010.00095] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The month of Ramadan holds great religious and social significance for Muslims all over the world. The aim of the present study was to provide a modified dialysis schedule for peritoneal dialysis (PD) patients that allows for fasting and that minimizes the effect on the patient's general health and volume status. METHODS We observed 31 patients under treatment at the PD unit of King Khalid University Hospital, King Saud University, Riyadh. During the 3 - 4 weeks before the start of Ramadan, all patients were counseled individually and in detail about the possibility of fasting. They were also provided with clear instructions about fluid intake (up to 1 L daily) and avoiding a high-potassium diet. Of the 31 patients, 18 (10 women, 8 men) elected to fast during the month of Ramadan. The mean duration of fast in the study year (2009) in Riyadh, Saudi Arabia, was about 14 hours: from 0415 h (before sunrise) to 1800 h (after sunset). Depending on membrane type and patient preference, the fasting group was shifted to one of two regimens: Modified continuous ambulatory PD (8 patients): 3 exchanges during the night (1.36% or 2.27%), and icodextrin for a long dwell during the day. The first dialysis exchange was performed immediately after breaking the fast (1900 h), and the next at 2300 h. The final exchange was performed in the early morning before sunrise (0300 h), when the icodextrin was infused. Modified continuous cycling PD (10 patients): exchanges (1.36% or 2.27%) were performed over 6 - 7 hours, and icodextrin was infused for a long dwell during the day. The patient connected to the cycler at 2000 h or 2100 h, and therapy finished at nearly 0300 h, with icodextrin as the last fill. RESULTS Of the study patients, 2 were admitted because of peritonitis (1 in each modality group), and the modified therapy was discontinued. In the modified CCPD group, 1 patient (on PD for 1 month before Ramadan) developed PD-related pleural effusion (proved by pleural fluid analysis), and PD was consequently discontinued. Hypotension developed in 2 patients of the CAPD group and 1 of the CCPD group during the first 2 weeks. In the CCPD group, 1 patient presented with lower limb edema and mild fluid overload. Overall, PD patients that opted to fast during Ramadan did not experience any serious morbidity or deterioration in renal function during their period of observance. No biochemical parameters or clearance studies showed a statistically significant p value. CONCLUSIONS In view of the study findings, we conclude that most stable patients on PD can fast, provided that they strictly adhere to their medications and dialysis therapy in addition to the dietary restrictions. These patients should be followed closely to detect any complications and to ensure that adequate fluid and electrolyte balance are maintained.
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Affiliation(s)
- Jamal Al Wakeel
- Department of Medicine, King Saud University, Riyadh, Saudi Arabia.
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Qurashi S, Tamimi A, Jaradat M, Al Sayyari A. Effect of fasting for Ramadan on kidney graft function during the hottest month of the year (August) in Riyadh, Saudi Arabia. EXP CLIN TRANSPLANT 2012; 10:551-3. [PMID: 22920156 DOI: 10.6002/ect.2012.0139] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To assess the effect of fasting Ramadan during the hottest month of the year in Riyadh, Saudi Arabia. MATERIALS AND METHODS This prospective cohort study was performed at the King Fahd National Guard Hospital in Riyadh, Saudi Arabia. We used the Modification of Diet in Renal Disease formula to estimate the glomerular filtration rate in renal transplant patients who fasted and did not fast before and after Ramadan. RESULTS There were 43 fasters and 37 nonfasters of comparable ages, with fasters having longer posttransplant times compared with nonfasters (P = .0001). The 2 groups had similar mean estimated glomerular filtration rates before Ramadan: 75.6 ± 29.2 and 65.9 ± 25.9 mL/min (P = .1) and similar mean estimated glomerular filtration rates 6 months after Ramadan: 77.2 ± 29.7 and 64.1 ± 29 mL/min (P = .21). Mean changes in the estimated glomerular filtration rate were similar in the 2 groups: -1.5 ± 10.9 and -2.8 ± 19.3 (P = .7) as was the percentage change (-0.2.2 ± 13.4 and 1.8 ± 15.9; P = .4). In the fasting group, serum creatinine and estimated glomerular filtration rate were similar before and 6 months after Ramadan: 105.1 ± 55 and 105.14 ± 61 μmol/L (P = 1.0) and 75.6 ± 29 and 72.2 ± 29.7 mL/min (P = .36). No significant changes were observed in the nonfasting group. No significant differences were detected regarding fasting in the estimated glomerular filtration rate before and 6 months after Ramadan in the 3 groups with the low, moderate, and high glomerular filtration rates at baseline. CONCLUSIONS Fasting for Ramadan in August does not adversely affect graft function at a mean follow-up of 7.6 ± 1.3 months.
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Affiliation(s)
- Salem Qurashi
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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