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.

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Aim: With the increasing life expectancy, the elderly population is gradually increasing. Considering the difficulty in recognizing and treating mental disorders in the elderly, clinicians should be careful about risk factors. This study aimed to investigate the relationship of chronic diseases with depression and anxiety levels and to raise awareness for mental illnesses in this age group. Material and Methods: This study was conducted with 100 patients over 65 years of age. Patients with a diagnosis of psychiatric illness and using psychotropic drugs for the last 6 months were not included in the study. After the sample of the study was formed, the sociodemographic data form prepared by the researchers and the Hospital Anxiety and Depression Scale were applied to the patients. Results: Anxiety levels were found to be significantly higher in female patients (p=0.032). A positive correlation was found between age and depression levels (r=0.225, p=0.025). No statistically significant difference was found in anxiety and depression levels between the patient groups with and without chronic disease (p=0.122, and p=0.668, respectively). Conclusion: Chronic diseases, duration of the disease, and use of medication were not found to be associated with anxiety and depression levels, while anxiety levels were found to be higher in female patients, and also a significant positive correlation was found between age and depression levels. Mental disorders are a subject that needs to be examined in detail in elderly patients. The mental illnesses of elderly patients should not be ignored and should always be considered by clinicians.

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