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| Reference | Methods | Outcomes |
|
| [58] | Prospective study from Riyadh, KSA, that included 32 fasting HD patients | No change in Kt/V, although creatinine increased and 25% of patients developed hyperkalemia. Despite the high frequency of fluid overload (>4% IDWG) accompanied by elevated BP, no hospitalization was needed |
| [67] | Retrospective analysis from Karachi, Pakistan, that evaluated mortality rates during Ramadan (1989–2012) in a cohort of 1,841 HD patients. Fasting status was unknown | Forty-nine percent of HD patients died during the study period. The highest rates of death in the Hijri calendar were observed during Ramadan (10.5% of the mortality) but this was attributed to dietary changes and/or cooler weather. Of note, the highest rates of death in the Gregorian calendar were in the cooler months of December and January |
| [68] | Prospective study from Riyadh, KSA, that included 407 fasting and 228 nonfasting HD patients | Increased number of missing sessions for fasting patients only. IDWG and pre and postdialysis BP were slightly but not significantly higher in the fasting group. No differences in serum potassium were observed during Ramadan |
| [60] | Prospective study from Nablus, Palestine, that divided HD patients into three groups: | The authors reported a higher mean IDWG among those participating in daily fasting and a slightly higher mean IDWG for those engaged in partial fasting (especially those with DM). Patients participating in daily fasting had higher serum potassium levels |
| Group 1: daily fasting (n = 31) |
| Group 2: fasting on non-HD days (n = 102) |
| Group 3: nonfasting (n = 136) |
| [70] | Prospective study from Mansura, Egypt, that included HD patients divided into three groups: | Younger patients with fewer comorbidities in the fasting groups exhibited lower mortality rates than older and sicker patients who were not fasting. All groups showed small but statistically significant drops in BP. Higher albumin levels were detected in fasting groups. Episodes of hypotension and hypoglycemia were more frequent in the fasting group |
| Group 1: daily fasting (n = 381) |
| Group 2: fasting on non-HD days (n = 574) |
| Group 3: nonfasting (n = 1090) |
| [71] | Prospective study from Karachi, Pakistan, that included 34 fasting and 252 nonfasting HD patients. Dates were not reported | Fasting resulted in a significant drop in diastolic BP only and an increase in albumin. No significant elevations in weight or serum potassium levels were observed |
| [72] | Prospective study from Kuala Lumpur, Malaysia, that included 35 fasting HD patients | Significant drop in predialysis weight gain that was even more prominent among nondiabetics. No significant changes in dry weight, IDWG, or serum potassium were observed. Significant increases in albumin in all groups, along with a significant drop in Hgb levels in diabetics |
| [73] | Prospective study from Klang Valley, Malaysia, that included 87 fasting HD patients (22% engaged in partial fasting) | Significant decreases in IDWG and waist circumference were observed in response to regular Ramadan fasting, especially among females. Significant decreases in phosphorus, albumin, urea, and creatinine were observed. No significant changes in diet were reported |
| [74] | Prospective study from Riyadh, KSA, that included 40 HD patients who were fasting on-off HD days. Clinical and laboratory parameters were compared to pre-Ramadan values. The study dates were not reported | Small but significant increases in IDWG and serum potassium levels were observed during Ramadan compared to pre-Ramadan, but no emergencies developed. No significant changes in BP were observed |
| [75] | Prospective study from Riyadh, KSA, that included fasting PD patients (8 CAPD and 10 CCPD) without a control group. A pre-Ramadan evaluation was performed to rule out any contraindications to fasting | Nutritional counseling was provided to ensure adherence to appropriate fluid, salt, potassium, and calorie intake to avoid dialysis emergencies. No changes in weight, urine output or Cr Cl were observed, nor were there any serious event |
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