Relation Between Health-Care Medical Provider Opinion and Hemodialysis Patient Attitude Toward Fasting in Ramadan

Abstract

Introduction: Muslim hemodialysis (HD) patients are motivated to practice fasting in Ramadan. Health-care providers may be unable to make a recommendation based on lack of evidence. The aim of the present study was to investigate patients’ and medical professionals’ opinion toward fasting in 4 HD centers in Egypt as well as the impact of physicians’ attitude on their patient behavior. Materials and Methods: This observational multicentric study was conducted on 161 patients undergoing HD and 23 physicians in 4 HD centers in Egypt just after Ramadan 1438 Hijri. Patients’ demographic characteristics as well as any associated comorbidities were recorded. Patients and physician were interviewed and were asked about their opinion toward fasting in HD patients and any experienced complications during fasting. Results: Eighty-one (50.3%) patients of the studied HD patients practiced fasting in Ramadan. No statistical difference was observed between fasting and nonfasting groups regarding age, gender, and duration of HD. Eighty percent of patients reported no complications. Fifteen (65.2%) physicians support the opinion that HD patients are capable to fast with precautions. There was a significant variation in fasting frequency among HD patients in the studied centers with a significantly low fasting frequency observed in the third center (10.5%). Most physicians from this HD center adopted that HD patients should not fast. Conclusion: HD patients were keen to practice fasting in Ramadan and were to a considerable extent capable of completing this Islamic worship. Patient decision seems to be affected by their physician’s opinion. Absence of clear recommendations to guide fasting in Ramadan in HD patients as in diabetic patients makes permission or prohibition of such practice unjustified.

Ramadan fasting in hemodialysis population: single-center study

“…In a previous report, 282 Pakistani HD patients were assessed by Imtiaz et al, and the frequency of fasting in Ramadan was 13.5% [ 5 ]. In another study conducted in Saudi Arabia, 64.1% out of the included 635 HD patients fasted [ 6 ]. The variation in the results of these studies and the current one could generally be ascribed to different personal, social, and environmental influences.…”

Therapeutic Fasting: Are Patients Aged 65 and Over Ready?

“…In our survey, a minority of respondents considered fasting to be a dangerous method, and about half of the respondents considered the positive opinion of their primary care physician as an enabler to perform therapeutic fasting. The decision to fast seems to be influenced by the opinion of the physician [ 40 ], although the lack of recommendations makes it difficult for them to make a stand. In addition, fasting, which is a voluntary deprivation of food, seems to be in contradiction with the current vision of medicine, which emphasizes the early management of undernutrition and the need to fight against cachexia.…”

Ramadan fasting in health and disease (2020): A narrative review

“…The majority of responding nephrologists (85.4%) were concerned about eGFR, diabetes (68.8%), patient age (64.6%), use of diuretics (62.5%), body fluid volume (60.4%), and BP (60.4%). This research in another study, El-Kannishy et al [20] investigated patients' and medical professionals' opinions toward fasting in four HD centers in Egypt and the impact of physicians' attitude on patient behavior. Patients and physicians were interviewed and asked about their opinion toward fasting in HD patients and any experienced complications during fasting.…”