The effect of Ramadan fasting on renal functions in patients with chronic kidney disease

Abstract

Objective We aimed to investigate the effects of Ramadan fasting on renal functions in patients with stage 3 and 4 chronic kidney disease. Materials and methods The study was conducted in Ramadan month which was between June and July. Patients were evaluated before Ramadan, the week immediately following the end of the Ramadan, and 3 and 6 months after Ramadan. Results Twenty-four fasting (mean age of 68 ± 13 years) and 55 non-fasting individuals (mean age of 69 ± 9 years) were included in this study. There was no statistically significant difference for creatinine levels in the first week after Ramadan in both groups compared to levels before Ramadan (p = 0.070, p = 0.470, respectively). The groups were compared according to the criteria of deterioration in renal function (reduction of 25% in GFR and 30% increase in serum creatinine levels). There were no statistically significant differences between the two groups according to these two criteria (p = 0.452, p = 0.660, respectively). In univariate and multivariate logistic regression analysis, the presence of diabetes mellitus and proteinuria were found to be independent risk determinants of renal dysfunction. Conclusion Patients with diabetes mellitus and prominent proteinuria may constitute critical patient groups for renal function deterioration during Ramadan fasting.

Ramadan fasting outcome among high-risk patients.

“…Although the number of adverse events was not signi cantly affected by fasting, the relatively high rate of adverse events (17 including one death), despite not fasting, seems to give some support to this advice. In our study, diabetes was not an associated factor with worse outcomes, unlike an earlier study that found both diabetes mellitus and proteinuria to be independent risk determinants of renal dysfunction 7 . However, this deserves further exploration, and glycemic control and duration of diabetes may be a factor of interest in future studies.…”

Puasa Ramadhan Dan Pengaruhnya Terhadap Progresifitas Penyakit Ginjal Kronik

“…Periode lama berpuasa bervariasi pada setiap negara, antara 12-18 jam yang bergantung pada faktor musiman dan regional. (5)(6)(7) Pengaruh puasa Ramadhan terhadap fisiologis dan biokimia tubuh telah banyak dipelajari dengan hasil yang berbeda-beda. Beberapa penelitian menunjukkan puasa Ramadhan dapat ditoleransi dengan aman pada orang sehat dan memberikan efek yang menguntungkan dalam hal regulasi tekanan darah, kadar lipid darah, stres oksidatif, sensitivitas insulin, dan penyakit jantung kronis jika dilakukan sesuai dengan tuntutan.…”

“…Pada beberapa penelitian lain menunjukkan puasa Ramadhan juga aman pada pasien diabetes, tidak memberikan efek samping yang signifikan pada penerima transplantasi ginjal dan pasien dengan batu saluran kemih. (6,8) Ada banyak kontroversi mengenai puasa Ramadhan untuk penderita PGK terutama apakah puasa tersebut memperbaiki indikator fungsi ginjal atau malah sebaliknya. Terdapat kekhawatiran tentang dampak dehidrasi dan efek hipoperfusi ginjal selanjutnya selama puasa Ramadhan terhadap penderita PGK.…”

“…Secara univariat dan analisis regresi logistik multivariat, adanya diabetes mellitus dan proteinuria menjadi penentu risiko independen dari disfungsi ginjal. (6) Pada penelitian yang dilakukan oleh Bakhit, dkk pada tahun 2017 di Saudi Arabia, terhadap 65 pasien dengan PGK stadium 3 atau lebih tinggi menunjukkan hasil adanya perburukan fungsi ginjal yang ditandai dengan peningkatan kadar rata-rata kreatinin, 206 µmol/l sebelum bulan Ramadhan, 214 µmol/l selama bulan Ramadhan dan 209 µmol/l pada waktu 3 bulan setelah Ramadhan. Total sebanyak 22 pasien atau 33,8% yang mengalami perburukan fungsi ginjal, dengan pembagian, 15 pasien mengalami perburukan saat bulan Ramadhan dan 7 pasien setelah 3 bulan Ramadhan.…”

“…Namun puasa Ramadhan bisa berdampak positif dalam hal keseimbangan elektrolit dan perubahan tekanan darah. (6,20) Satu studi tunggal terhadap 40 pasien yang menerima terapi hemodialisis lebih dari 6 bulan yang meneliti efek puasa selama Ramadhan. Pasien berpuasa pada hari non-dialisis.…”