Ramadan fasting in hemodialysis population: single-center study

Abstract
Background
Fasting Ramadan is one of the fundamental pillars of Islam. Although sick people are excluded from this duty, some of the hemodialysis patients insist to fast to enjoy the spiritual nature of the holy month.

Objectives
To monitor the tolerability of fasting Ramadan among the hemodialysis population.

Methodology
One hundred ninety-nine prevalent hemodialysis (HD) patients participated in the study and were allocated to 3 groups according to their fasting decision (complete, partial, and non- fasting). Basic demographic and laboratory data were collected before the start of the holy month; monitoring any inter or intradialytic complications or events during the holy month was done in addition to dry weight monitoring before and at the end of the month.

Results
One hundred ninety-nine HD patients were included (97 males, mean age 45 ± 15 SD). Patients were divided based on their fasting state into 3 groups: compete fasting 28 (14%), partial fasting 88 (44%), and non-fasting 83 (42%). Out of 116 total fasting patients, only 4 patients (3.4%) developed complications (intradialytic hypotension (IDH) and muscle cramps) during dialysis. On the other hand, 3 patients experienced improvement of IDH; also, one patient reported improvement in dyspepsia. We noted a significant reduction in dry weight in the complete and partial fasting groups (P < 0.001 for both), unlike the non-fasting group (P = 0.75).

Conclusion
We may conclude that fasting Ramadan in hemodialysis patients whether complete or partial fasting may be tolerated by most of patients and was associated with a significant reduction in dry weight.