title: The impact of Ramadan fast on patients with gout.
abstract: BACKGROUND
  Ramadan fast is a religious custom in Islam. Increased serum uric acid level during this month had been reported in past studies of nongout patients.
  
  
  OBJECTIVE
  The objective of this study was to assess the impact of Ramadan fast on patients with gout.
  
  
  METHODS
  All Moslem patients with gout from the registry of Nazareth Hospital, who intended to fast during Ramadan, were asked to participate in our study (group 1). Data regarding age, gender, income, education, duration of gout, meds, adherence to low-purine diet, and gouty attacks were documented. Age- and gender matched Moslem patients from the same registry, but who did not intend to fast during Ramadan, were asked to participate as a control group (group 2). Just prior to and at the end of Ramadan, blood for uric acid, creatinine, and urea levels were obtained as well as body mass index, from all the patients. During Ramadan, patients were monitored for gouty arthritis or renal calculi attacks, as well as low-purine diet and medicine adherence.
  
  
  RESULTS
  Twenty-one and 22 patients from groups 1 and 2, respectively, completed the study. Mean serum uric acid, urea, creatinine, and body mass index levels at the end of Ramadan fasts in group 1 patients were 8.11 mg/dL, 26.38 mmol/L, 0.87 mg/dL, and 31.0 kg/m, respectively, as compared with 7.92 mg/dL (P = 0.707), 24.54 mmol/L (P = 0.769), 0.84 mg/dL (P = 0.180), and 30.5 kg/m (P = 0.907) respectively, obtained just prior to the fast. No significant change in any parameter was seen also in group 2 patients. There also was no significant change between the 2 groups in arthritis or renal calculi attacks and also in medication and low-purine diet adherence, during Ramadan.
  
  
  CONCLUSIONS
  There was no risk for a significant increase in gouty arthritic/renal calculi attacks or serum uric acid in patients with gout during Ramadan fast.
authors.affiliation: From the *Department of Medicine, Carmel Medical Center; and †Faculty of Medicine, Technion, Israel Institute of Technology, Haifa; and ‡Rheumatology Clinic, Nazareth Hospital, Nazareth; §Department of Neurology, ║Department of Medicine, Carmel Medical Center, and ¶Department of Orthopedics, Carmel Medical Center, Haifa; #Diet Unit, Carmel Medical Center; and Departments of **Orthopedics and ††Radiology, Nazareth Hospital, Nazareth, Bar-Ilan Medical School, Tzfat, Israel.
authors.forename: George
authors.initials: G
authors.lastname: Habib
authors.forename: Samih
authors.initials: S
authors.lastname: Badarny
authors.forename: Maroun
authors.initials: M
authors.lastname: Khreish
authors.forename: Fadi
authors.initials: F
authors.lastname: Khazin
authors.forename: Vivian
authors.initials: V
authors.lastname: Shehadeh
authors.forename: Geries
authors.initials: G
authors.lastname: Hakim
authors.forename: Suheil
authors.initials: S
authors.lastname: Artul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D015992:Body Mass Index; D016022:Case-Control Studies; D003078:Colchicine / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D005215:Fasting / Q000502:physiology*; D005260:Female; D006073:Gout / Q000097:blood* / Q000150:complications* / Q000628:therapy; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D007514:Islam; D007557:Israel; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D014508:Urea / Q000097:blood; D014527:Uric Acid / Q000097:blood*
chemical_list: D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol; D014508:Urea; D003404:Creatinine; D003078:Colchicine