Background There is a growing literature on guidelines regarding Ramadan fasting for chronic kidney disease (CKD) patients. However, most studies only consider the impact of fasting on renal function. This study additionally aims to assess factors influencing Ramadan fasting in patients with CKD. Method This is a prospective before and after cohort study. CKD patients were counseled regarding fasting and followed-up post-Ramadan for renal function status, actual fasting behavior, and other relevant outcomes. Results Of the 360 patients who attended the pre-Ramadan consultation, 306 were reachable after Ramadan of whom 55.3% were female. Of these 306 67.1% reported that they had fasted, 4.9% had attempted to fast but stopped, and 28% did not fast at all. Of these 74 has a post-fasting kidney test. Of the patients, 68.1% had stage 3A CKD, 21.7% had stage 3B, 7.9% stage 4, and only 2% stage 5. Of those who fasted, 11.1% had a drop in Glomerular Filtration Rate (eGFR) of 20% or more. Those who did not fast (16.7%) presented a similar drop. Conversely, among the few who attempted to fast and had to stop, half showed a drop in eGFR of more than 20%. In linear regression, fasting was not associated with post-Ramadan eGFR, when controlling for age and baseline eGRF. There were 17 (5.6%) significant events, including one death. More significant events occurred among the group who fasted some of Ramadan days, 26.7% of the subjects experienced an adverse event—while 4.7% of the group who did not fast had a significant adverse event compared to 4.4% among those who fasted all Ramadan. Conclusion Fasting was not a significant determining factor in renal function deterioration in the study’s population, nor did it have any significant association with adverse events.

Background:The literature is building for guiding the decision for Chronic Kidney Diseases, CKD, patients fasting Ramadan. However, it is mainly considering one outcome, the impact on renal function. This study aims to assess factors influencing Ramadan fasting in patients with CKD.Method:This is a prospective before and after cohort study. CKD patients were consoled regarding fasting as part of a quality project and followed Ramadan for renal function status, fasting Ramadan, and other significant outcomes. Results:Of these 360 patients who attended the pre-Ramadan consultation, 304 were reachable after Ramadan, and 67.1% of them reported that they did fast, 4.9% attempted to fast but had to stop, and 28% did not fast a single day. They were 55.3% females, compared to 44.7% males (69.9%). They were; stage 3A (68.1%), stage 3B 21.7%, stage 4 7.9% and only 2% were stage 5. Of those who did fast, 11.1% had a drop of eGFR of 20% or more. While those who did not fast (16.7%) had a similar drop. On the other hand, among the few who attempted to fast and had to stop fasting, half had a drop in eGFR of more than 20%. In linear regression, when controlling for the CKD stage, age, gender, and comorbidity, the only predictor of drop-in eGFR was a higher percentage of the drop since last year and a lower eGFR before Ramadan. There were 17 (5.6%) significant events, including one death. More significant events were among the group who did fast, where 50% experienced an adverse event, while 16.7% were among the group who did not fast and 11.1% were among those who did fast. Conclusion:Fasting was not a significant determinantal factor in renal function deterioration in the studies population, neither was it having any significant association with adverse events.