The presentation aims to review the literature regarding effects of Ramadan fasting on patients with hypertension and different kidney diseases.

1. Ramadan Fasting Effect on Patients
with Hypertension and Kidney
Diseases: A Literature Review
Dr
Yasser Matter
Nephrology and Kidney Transplantation
Specialist
Urology and Nephrology center
Mansoura University -Egypt
yassermatter86@gmail.com
yassermatter@mans.edu.eg

2. • Ramadan fasting is one of the five pillars of Islam and is
compulsory for all adult Muslims who had no medical or
religious excuses.
• Ramadan fasting is defined as a complete abstinence from
food, drink, medications, sexual activity, and smoking from
dawn to dusk.
• Regarding the kind Islamic religion, patients have
permission not to fast after medical advice However, most
Muslim patients express their desire to fast Ramadan month
and they are very broken when their physicians inform them
not to fast.
• The presentation aims to review the literature regarding
effects of Ramadan fasting on patients with hypertension and
different kidney diseases.

3. Ramadan Fasting on Blood
Pressure
Ramadan Fasting & Hypertension

4. • This systematic review suggested that
Ramadan fasting can be safe in treated
essential hypertensive patients with
continuation of previous medications. Also
it can improve systolic and diastolic blood
pressures.
Feb 2016

5. Ramadan Fasting & Renal
Transplantation

6. Nearly all available studies suggested that
Ramadan fasting is safe when the function of
the renal graft is acceptable and stable.
No study has reported any bad effects of
Ramadan fasting for the transplanted
kidneys.
Ramadan fasting and patients with renal diseases: A mini review of
the literature. J Res Med Sci. 2013 Aug;18(8):711-6.

8. Ramadan Fasting & CKD

9. The existing data in the literature
are scarce and give inconclusive
results with controversy.
There are no guidelines or standardized
protocols that can help physicians to
properly address the issue of patients with
chronic kidney disease (CKD) fasting in
Ramadan and to correctly advise them.
Ramadan fasting and patients with renal diseases: A mini review of
the literature. J Res Med Sci. 2013 Aug;18(8):711-6.

10. Included 39 CKD patients and 32 HD patients . 14-hour fasting for one month was
tolerated by CKD (all stages ) and hemodialysis patients, although there were
considerable changes among hemodialysis patients in some of the blood
chemistry variables. No serious adverse events occurred.
Included 65 patients with stage 3 or higher CKD ,
Ramadan fasting during the summer months was associated with worsening of
renal function. Clinicians need to warn CKD patients against Ramadan fasting.

11. Clinical recommendations for
patients willing to fast
They should break the fasting if the
plasma creatinine increases by the 30%
above the baseline values and/or if you
observe clinical symptoms due to
changes in serum potassium and sodium.

12. Patients should be monitored during Ramadan and should be
instructed to recognize some alarm symptoms such as an
increase in weight (>2 kg from the baseline), lower limb
or facial swelling, shortness of breath, dizziness, anorexia
, fatigue, weakness or lethargy.
Body weight, blood pressure, biochemical parameters
such as fluid and electrolytes should be regularly checked
throughout the Ramadan. Patients should attend regular
follow-up every 1-2 weeks, before, during and after
Ramadan.
Bragazzi NL. Ramadan fasting and chronic kidney disease:
A systematic review. Journal of Research in Medical
Sciences : The Official Journal of Isfahan University of
Medical Sciences. 2014;19(7):665-676.

13. Ramadan Fasting &
Haemodialysis

14. The existing data in the literature are
scarce and give inconclusive results
with controversy.
There are no guidelines or standardized
protocols that can help physicians to properly
address the issue of patients with chronic
haemodialysis fasting in Ramadan and to
correctly advise them.

15. Included 40 patients. We found a significant increase in interdialytic weight gain
and potassium level during Ramadan but no significant changes in blood pressure,
plasma sodium, creatinine, urea or phosphate
Included 635 patients (64% fasting vs 36%non fasting )
There were no differences in the pre- and post-dialysis blood pressure; serum
potassium, albumin or weight gain; diabetic status; and dialysis shift time or
days.
serum phosphorous was significantly higher in the fasting group.
Fasters were significantly younger and more likely to be working, to
miss dialysis sessions, and to have higher serum phosphorous levels

16. included 35 patients .Ramadan fasting is associated with reduced weight,
improved serum albumin and phosphate level in our population
of haemodialysis patients
1,841 patients from January 1989 to December 2012 at single center were
reviewed.
Ramadan reflected a higher frequency of death. Therefore, there is a
need to evaluate the risk factors in a prospective study so that the dialysis
patients can be better managed during this period.

17. Ramadan Fasting & Stone
Kidney Disease

18. In brief, there is still no strong evidence that
reveals whether Ramadan fasting can induce
renal stone formation in susceptible patients or
not.
Despite such controversies, nearly all studies
are in agreement on consuming adequate
amounts of water from dusk to dawn to reduce
the potential risk of dehydration in developing
renal stones.
Ramadan fasting and patients with renal diseases: A mini review of
the literature. J Res Med Sci. 2013 Aug;18(8):711-6.

19. compared the number of patients admitted with renal colic between the
four periods of i) 2 weeks before Ramadan, ii) the first 2 weeks of
Ramadan, iii) the second 2 weeks of Ramadan, and, iv) 2 weeks after the
month of Ramadan
conclusion :
The number of renal colic admissions was the highest in the first 2
weeks of Ramadan and there was an association between Ramadan
fasting and the incidence of renal colic admissions.

22. Home Messages

23. Who are exempted
from fasting during Ramadan?

24. Who can fast during Ramadan?