Ramadan Fasting in Chronic Kidney Disease Patients: A Descriptive Observational Study

Background: According to Islamic rules, a Muslim is requested to abstain from food, water, smoking, medications, and sexual activities from dawn until dusk, every day during the month of Ramadan. While Islam rules allow patients with appreciable illnesses not to fast, many Muslims, with chronic diseases, tend to stick to fasting, even against medical advice. However, there is no consensus among treating physicians regarding the fasting of Ramadan of patients in various stages of chronic kidney disease (CKD), especially those who insist on fasting regardless of their health problems.

Aim of the Work:We aimed to observe the practice of Ramadan fasting of CKD patients of different disease stages and its effect on CKD progression.

Methods and Subjects:The study observed sixty-three patients who were followed regularly at the Nephrology Outpatient Clinic in Mansoura Military Hospital, before, during, and after the month of Ramadan during summer in the years 2016-2019 to evaluate the effect of fasting on the patients and their kidneys. The study comprised two groups that comprised fifty fasting patients and thirteen in non -fasting group.

Results:The examined CKD patients included 47 males and 16 females who comprised 50 patients who practised fasting and 13 patients who did not fast the months of Ramadan according to their own will. Their ages ranged between 27 and 77 years. Forty-nine patients did not progress to end-stage renal disease (ESRD), while the remaining fourteen patients ended with dialysis during the study.Neither urea nor creatinine changes had statistically significant differences between patients who had and who had not fasted. In addition, differences in creatinine slope values between those who fasted did not show any statistical significance. Fourteen of the studied patients progressed to the need for dialysis; their mean age was 62 years. Of them, those who fasted included 3 patients of stage 4 and 6 patients of stage 5. Furthermore, the frequency of patients who started dialysis directly after Ramadan (six patients; 66.7%) were lower in the fasting group. Of the studied patients, seven had renal stones and opted to fast. All of them experienced occasional attacks of loin pain that increased during the first two weeks of fasting but decreased in the last two weeks of the month of Ramadan.

Conclusion: Compared to non-fasting, Ramadan fasting does not cause a significant extra risk of renal disease progression.