Status of fasting in Ramadan of chronic hemodialysis patients all over Egypt: A multicenter observational study

Megahed, Abir Farouk; El-Kannishy, Ghada; Sayed‐Ahmed, Nagy

doi:10.4103/1319-2442.256841

Cited by 13 publications

(7 citation statements)

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“…Despite this, the literature suggests that significant proportions of hemodialysis patients still decide to fast during Ramadan. For example, one large multicenter study in Egypt reported that out of 2055 hemodialysis patients 18.5% and 28.4% chose to fast daily or partially during Ramadan in 2016, respectively [23]. The aim of this prospective cohort study was to examine effects of daily Ramadan fasting and partial Ramadan fasting on key biochemical and clinical markers among hemodialysis patients as compared to hemodialysis patients who chose not to fast during Ramadan.…”

Section: Introductionmentioning

confidence: 99%

The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study

et al. 2019

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Background Ramadan fasting is compulsory for all healthy adult Muslims. Although sick people are exempted from Ramadan fasting, some patients such as hemodialysis patients prefer to fast during Ramadan. The effect of Ramadan fasting on clinical outcomes and biochemical markers among hemodialysis patients is not clear. The aim of this study was to examine the effects of daily Ramadan fasting and partial Ramadan fasting on key biochemical and clinical markers among hemodialysis patients as compared to hemodialysis patients who chose not to fast during Ramadan. Methods A prospective cohort study of 269 end stage renal disease patients were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. The participants were divided into three cohorts based on their plans for fasting during Ramadan in May 2018; Ramadan fasting group (RFG), Ramadan partial fasting group (RPFG) and Ramadan not-fasting group (RNFG). Key clinical and biochemical markers were measured before, during and after Ramadan. Results After adjustment for diabetic and hypertension status and other sociodemographic variables, RFG had higher mean inter-dialytic weight gain (IDWG) by 0.62 kg than RNFG (95% confidence interval (CI) 0.26, 0.99). RPFG also had slight increase in mean IDWG than RNFG by 0.35 kg (95% CI 0.11, 0.60). Additionally, RFG and RPFG had significant increase in mean serum potassium as compared to RNFG. Diabetes was independently associated with increased IDWG by 0.48 kg (0.25, 0.72). Diabetes and hypertension were associated with some independent changes in biochemical markers, but these were clinically negligible. Conclusion Our findings suggest that Ramadan fasting (fully or partially) is tolerable by hemodialysis patients and is not associated with important clinical complications. However, these patients should be made aware of the potential risk of fluid overload and hyperkalemia, if they decide to fast during Ramadan. Thus, they should be closely monitored and instructed to adhere to their dietary and fluid intake allowances. Further prospective cohort studies with comprehensive dietary measures and information on adverse clinical outcomes may provide more evidence about the tolerability and safety of Ramadan fasting by hemodialysis patients.

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Section: Introductionmentioning

confidence: 99%

The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study

et al. 2019

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“…Reports form the Middle East showed different results. A study from Egypt involving 2055 HD patients revealed significant elevation of the mean phosphorus, creatinine, and albumin levels with Ramadan fasting [2]. Another study from Iran showed significant elevation of serum phosphorus, creatinine albumin, and uric acid with Ramadan fasting [10].…”

Section: Discussionmentioning

confidence: 99%

“…The investigators concluded that nearly 47% of the study patients fasted at least few days of Ramadan. They recommended that HD patients should be encouraged to discuss the option of fasting in Ramadan with their HD staff who might be able to give advice on whether to allow them to fast in days off dialysis with special precautions regarding associated comorbidities, especially diabetes and coronary artery disease [2].…”

Section: Introductionmentioning

confidence: 99%

Effect of Ramadan fasting on chronic inflammation markers and gut bacterial endotoxins among Egyptian hemodialysis patients

et al. 2023

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Background Chronic kidney disease (CKD) is associated with a state of chronic inflammation. This study aimed to investigate effects of Ramadan fasting on the markers of chronic inflammation and gut bacterial endotoxin levels in maintenance hemodialysis. Method A prospective self‐controlled observational study included 45 patients. Serum levels of High Sensitive CRP (hsCRP), indoxyl sulfate, and trimethylamine‐n‐levels were measured within a week before and a week after Ramadan fasting. Results Twenty‐seven patients have fasted more than 15 days (29 ± 2.2 days). The levels of high sensitive C‐reactive protein (hsCRP) (median of 62 mg/L vs. 91 mg/L), trimethylamine‐n‐oxide (TMAO) (median of 4.5 μmoL/L vs. 17 μmoL/L), platelet‐to‐lymphocyte ratio (PLR) (mean of 98.9 mg/L vs. 111.8 mg/L) and neutrophil‐to‐lymphocyte ratio (NLR) (median of 1.56 vs. 1.59) were significantly lower after Ramadan fasting with p < 0.001, p < 0.001, p < 0.001, and p = 0.04, respectively. Conclusion A beneficial effect of Ramadan fasting on levels of bacterial endotoxins and markers of chronic inflammation in hemodialysis patients was observed.

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“…Four of the prospective studies included a nonfasting control group, and three were conducted during the summer months [68][69][70]. One was a multicenter study that evaluated patients before and during Ramadan but did not report the statistical analysis method used.…”

Section: Ramadan Fasting and Dialysismentioning

confidence: 99%

The Impact of Hot Ambient Temperature and Prolonged Fasting Duration during Ramadan on Patients with Chronic Kidney Disease: A Literature Review

AlSahow

2023

International Journal of Nephrology

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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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Status of fasting in Ramadan of chronic hemodialysis patients all over Egypt: A multicenter observational study

Cited by 13 publications

References 0 publications

The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study

The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study

Effect of Ramadan fasting on chronic inflammation markers and gut bacterial endotoxins among Egyptian hemodialysis patients

The Impact of Hot Ambient Temperature and Prolonged Fasting Duration during Ramadan on Patients with Chronic Kidney Disease: A Literature Review

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