Renal diseases and Ramadan: A review of the literature

Background & Aim: Changes in the dietary pattern and the timing of medications during the Ramadan fast could influence the outcomes of renal diseases in fasting patients. The aim of this study was to review the literatureon the effects of fasting during Ramadan on kidney diseases. Methods: Citations were extracted from PubMed and the Medline database from 1991 through 2013using the keywords “renal diseases”, “Ramadan” and “fasting”. The First International Congress on Ramadan and Health was also reviewed. Results: High temperatures, rather than Ramadan fasting, appear to be a risk factor for nephrolithiasis. Ramadan fasting may be injurious to renal tubules in pre-dialysis patients withchronic kidney disease (CKD), but the patients on peritoneal dialysis did not experience any serious complications from fasting. Fasting on non–hemodialysis days may expose patients to weight gain and hyperkalemia with no significant acute complications.The hyperkalemia reported by ESRD patients during fasting was not significant and could be due to insulinopenia and a defective response to epinephrine. Fasting for Ramadan does not appear to adversely affect graft function or increase rejection ratesamong thekidney transplant recipients who have had stable graft function for 1y. Conclusion: There was not enough evidence to suggest that fasting has harmful effects on patients with renal disease or renal transplantation. Most patients with stable renal diseases or a functioning transplant can fast without experiencing significant deterioration in renal function. The patients with CKD with or without dialysis are at risk of hyperkalemia while fasting, especially if they have diabetes. Therefore, CKD patients should be meticulously followed during Ramadan, adhere to a proper diet, continue taking medications and receiving dialysis; they should stop fasting if any deterioration occurs. [Inass Taha. Renal diseases and Ramadan: A review of the literature. Life Sci J 2013;10(3):450-458] (ISSN:1097-8135). http://www.lifesciencesite.com. 66