title: Fasting in Ramadan is not associated with deterioration of chronic kidney disease: A prospective observational study.
abstract: Although not mandatory for patients, many Muslims fast in Ramadan. We aimed to investigate the effects of long hours (17.5) fasting on renal functions in patients with chronic kidney disease (CKD). Stage 3-5 CKD patients with stable renal function were recruited to this prospective observational study three months ahead of Ramadan in 2015. All patients were instructed regarding possible deleterious effects of dehydration caused by fasting. Forty-five patients (mean age 66.8 ± 10.3 years, 68.8% male) chose to fast and 49 (mean, age: 64.1 ± 12.6 years, 51% male) chose not to fast. Clinical and laboratory data were recorded before and after Ramadan. Baseline clinical and laboratory parameters were similar in the two groups, except for higher serum creatinine and lower estimated glomerular filtration rate (eGFR) in the nonfasting group (2.22 ± 0.99 vs. 1.64 ± 0.41 mg/dL, P <0.001 and 3 1.9 ± 12.4 vs. 42.6 ± 9.8 mL/min, P <0.001, respectively). More than 30% elevation in serum creatinine after Ramadan occurred in 8.8% and 8.1% of fasting and nonfasting patients, respectively (P = 0.9). More than 25% drop eGFR after Ramadan was noted in seven (15.5%) and six (12.2%) fasting and nonfasting patients, respectively (P = 0.642). Patients with ≥ 25% drop in eGFR (13 vs. 81) were older (72.3 ± 8.3 years vs. 64.3 ± 11.7 years, P = 0.020) and more frequently using diuretics (69.2% vs. 35.8%, P = 0.023). In multiple linear regression analysis, only advanced age was found to be associated with ≥25% drop in eGFR after Ramadan in the fasting group. Fasting during Ramadan was not associated with increased risk of declining in renal functions in patients with Stage 3-5 CKD. However, elderly patients may still be under a higher risk.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Kara
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Osman Zikrullah
authors.initials: OZ
authors.lastname: Sahin
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Bayram
authors.initials: B
authors.lastname: Kizilkaya
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Ozturk
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Pusuroglu
authors.affiliation: Department of Internal Medicine, Division of Nephrology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
authors.forename: Safak
authors.initials: S
authors.lastname: Yildirim
authors.affiliation: Department of Nephrology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sevinc
authors.affiliation: Department of Nephrology, Sisli Hamidiye Etfal Educational and Research Hospital, Istanbul, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Sahutoglu
mesh_terms: D000368:Aged; D018450:Disease Progression; D005215:Fasting / Q000009:adverse effects; D005260:Female; D006693:Holidays; D006801:Humans; D007514:Islam; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000503:physiopathology*; D018570:Risk Assessment; D012307:Risk Factors; D014421:Turkey