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| Reference | Methods | Outcomes |
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| [59] | Prospective study from Tehran, Iran, that evaluated 24-hour urine volume and total calcium, phosphorous, and magnesium excretion in 57 fasting men, including 37 with a history of calcium calculi | Urine calcium was significantly lower and urine uric acid, citrate, phosphorus, sodium, and potassium were significantly higher during fasting compared to nonfasting state. Uric acid supersaturation increased, and calcium phosphate supersaturation decreased significantly during fasting. No significant increase in calcium oxalate supersaturation or risk of calculus formation during fasting |
| [60] | Single-center prospective study from Kuala Lumpur, Malaysia, (date not reported) that evaluated 24-hour urine samples collected from 20 healthy fasting men before, weekly during, and one to four weeks after Ramadan | No significant changes in 24-hour urine volume were observed. Lower 24-hour urine sodium levels, higher urine osmolality, and decreased urine titratable acidity were reported. No protein, glucose, urobilinogen, ketones, or hemoglobin were detected |
| [61] | Retrospective cross-sectional study from Riyadh, KSA, that included 237 consecutive patients presenting to an emergency department with renal colic only during Ramadan in 1998–2002 (Dec–Feb) and 2011–2015 (Jun–Aug). The incidence of renal colic during Ramadan in the five years in which it occurred in winter versus summer months was compared to the incidence during both summers and winters that did not include Ramadan | Fasting was not confirmed. Nephrolithiasis was confirmed by computed tomography. Thirty-seven percent of the patients were male. The risk of developing urinary stones during Ramadan was similar to the risk observed in nonfasting months. However, Ramadan fasting during the summer may increase the risk of stones in the ureters compared to those presenting at other locations when compared to Ramadan fasting during the winter months |
| [62] | Prospective study from Mashhad, Iran that included 610 patients admitted for renal colic who had been diagnosed clinically two weeks before, during, and two weeks after Ramadan (i.e., between Aug and Oct of 2008) | The incidence of renal colic was highest during the first two weeks of Ramadan when compared with the other periods evaluated. However, incidence declined during the last two weeks of Ramadan; this decline continued after Ramadan. The authors ruled out ambient temperature as a risk factor. Values for eGFR were not reported |
| [63] | Retrospective study from Manama, Bahrain that included 809 Muslims admitted with renal colic during the month before, the month of, and the month after Ramadan over a two-year period (2018 and 2019). Renal colic was diagnosed clinically (not radiologically). Fasting was assumed | The number of admissions during Ramadan (38.2%) and the month following (37.1%) was significantly higher than the number of cases in the month just before Ramadan (24.7%). The impact of temperature differences between the three periods was not evaluated. Kidney function was not reported |
| [64] | Multicenter retrospective study from Varamin, Iran, that included 574 subjects admitted with a diagnosis of renal colic from Mar 1, 2000, to Mar 1, 2001. Incidence over the 12-month period was reported | Number of hospital admissions for renal colic during Ramadan was not significantly different from mean number of admissions for renal colic during any of the other months of the lunar year. Mean admissions during the warmer seasons were significantly higher than during Ramadan |
| [65] | Single-center retrospective study from Jeddah, KSA, that included male patients seen in the emergency department for renal colic and who were diagnosed clinically one month before, during, and one month after Ramadan over three years (Mar-Apr/1992, Feb-Mar/1993, and Feb-Mar/1994) | Significant correlation with ambient temperature but not with fasting (which took place during the cooler months) or humidity. Fasting status and kidney function were not reported |
| [66] | Prospective single-center study from Lahore, Pakistan, that reported the incidence of clinically-diagnosed renal colic | A similar number of emergency department visits were reported during the months of Ramadan and Shawal despite the warmer weather during Ramadan |
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