Impact of Ramadan fasting on kidney function and related outcomes in patients with chronic kidney disease: a systematic review protocol

Abstract

IntroductionFasting during the month of Ramadan is a significant Islamic religious practice that involves abstinence from food, drink and medication from dawn to dusk. As just under a quarter of the world’s population identifies as Muslim, the effect of fasting on chronic conditions, such as chronic kidney disease (CKD) is a topic of broad relevance. To date, the information in this area has been mixed, with many limitations of previous studies. This study aims to synthesise the evidence of the effect of Ramadan fasting on changes on kidney function, risk factors, episodes of acute kidney injury and impact on the quality of life in patients with CKD or kidney transplant.Methods and analysisA systematic review of the literature will be conducted, using electronic databases such as MEDLINE, Embase, Global Health, CINAHL and Scopus. Original research and grey literature on the effect of Ramadan fasting in adult patients with CKD or renal transplantation will be included. Two reviewers will independently screen articles for inclusion in the review and independently assess the methodology of included studies using a customised checklist. Mean difference or risk ratio will be reported for continuous or dichotomous outcomes and results will be pooled using a random-effects model where heterogeneity is reasonable. If possible, subgroups (CKD status, setting, season and risk of bias) will be analysed for effect modification with fasting and the outcomes of interest. Risk of bias will be assessed using the Downs and Black checklist.Ethics and disseminationThe results will be disseminated using a multifaceted approach to engage all stakeholders (patients, practitioners and community leaders). Research ethics board approval is not required as this is a systematic review of previously published research.PROSPERO registration numberCRD42018088973.

Ramadan Fasting in Germany (17–18 h/Day): Effect on Cortisol and Brain-Derived Neurotrophic Factor in Association With Mood and Body Composition Parameters

“…RF is performed from dawn to sunset for 29–30 days. Due to geographical differences, the time periods of RF vary from 9 to 22 h per day ( 2 ). In this study, RF was performed for 17–18 h/day.…”

Consensus recommendations on fasting during Ramadan for patients with kidney disease: review of available evidence and a call for action (RaK Initiative)

“…These two meta-analyses were conducted in 2014 and 2015, respectively. More recently, Bello et al [ 20 ] published their protocol for a systemic review in 2019, but the final results have not yet been reported.…”

Alterations in anthropometric, inflammatory and mental health parameters during Ramadan intermittent fasting in a group of healthy people: a prospective cohort study

“…Ramadan intermittent fasting (RIF) is one type of IF that performed by about 1.5 billions of Muslims worldwide annually from dawn to sunset for one month. The time periods of RIF vary from 9 to 22 h per day due to geographical differences and seasonal variation ( 4 ). Food, water, smoking and sexual activities are forbidden during the fasting daytime hours of Ramadan month.…”