The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study

<h3>Background</h3><p dir="ltr">Ramadan fasting is compulsory for all healthy adult Muslims. Although sick people are exempted from Ramadan fasting, some patients such as hemodialysis patients prefer to fast during Ramadan. The effect of Ramadan fasting on clinical outcom...

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Main Author: Emad Khazneh (4901830) (author)
Other Authors: Jamal Qaddumi (4745448) (author), Zakaria Hamdan (6871712) (author), Falasteen Qudaimat (6871715) (author), Asmaa Sbitany (6871718) (author), Kamel Jebrin (6871721) (author), Osama Sawalmeh (6871724) (author), Yousef Abuiram (6871727) (author), Mujahed Shraim (633498) (author)
Published: 2019
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author Emad Khazneh (4901830)
author2 Jamal Qaddumi (4745448)
Zakaria Hamdan (6871712)
Falasteen Qudaimat (6871715)
Asmaa Sbitany (6871718)
Kamel Jebrin (6871721)
Osama Sawalmeh (6871724)
Yousef Abuiram (6871727)
Mujahed Shraim (633498)
author2_role author
author
author
author
author
author
author
author
author_facet Emad Khazneh (4901830)
Jamal Qaddumi (4745448)
Zakaria Hamdan (6871712)
Falasteen Qudaimat (6871715)
Asmaa Sbitany (6871718)
Kamel Jebrin (6871721)
Osama Sawalmeh (6871724)
Yousef Abuiram (6871727)
Mujahed Shraim (633498)
author_role author
dc.creator.none.fl_str_mv Emad Khazneh (4901830)
Jamal Qaddumi (4745448)
Zakaria Hamdan (6871712)
Falasteen Qudaimat (6871715)
Asmaa Sbitany (6871718)
Kamel Jebrin (6871721)
Osama Sawalmeh (6871724)
Yousef Abuiram (6871727)
Mujahed Shraim (633498)
dc.date.none.fl_str_mv 2019-06-24T03:00:00Z
dc.identifier.none.fl_str_mv 10.1371/journal.pone.0218745
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/The_effects_of_Ramadan_fasting_on_clinical_and_biochemical_markers_among_hemodialysis_patients_A_prospective_cohort_study/25348285
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Medical dialysis
Diabetes mellitus
Adverse events
Cohort studies
Creatinine
Diet
Educational attainment
Medical risk factors
dc.title.none.fl_str_mv The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Ramadan fasting is compulsory for all healthy adult Muslims. Although sick people are exempted from Ramadan fasting, some patients such as hemodialysis patients prefer to fast during Ramadan. The effect of Ramadan fasting on clinical outcomes and biochemical markers among hemodialysis patients is not clear. The aim of this study was to examine the effects of daily Ramadan fasting and partial Ramadan fasting on key biochemical and clinical markers among hemodialysis patients as compared to hemodialysis patients who chose not to fast during Ramadan.</p><h3>Methods</h3><p dir="ltr">A prospective cohort study of 269 end stage renal disease patients were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. The participants were divided into three cohorts based on their plans for fasting during Ramadan in May 2018; Ramadan fasting group (RFG), Ramadan partial fasting group (RPFG) and Ramadan not-fasting group (RNFG). Key clinical and biochemical markers were measured before, during and after Ramadan.</p><h3>Results</h3><p dir="ltr">After adjustment for diabetic and hypertension status and other sociodemographic variables, RFG had higher mean inter-dialytic weight gain (IDWG) by 0.62 kg than RNFG (95% confidence interval (CI) 0.26, 0.99). RPFG also had slight increase in mean IDWG than RNFG by 0.35 kg (95% CI 0.11, 0.60). Additionally, RFG and RPFG had significant increase in mean serum potassium as compared to RNFG. Diabetes was independently associated with increased IDWG by 0.48 kg (0.25, 0.72). Diabetes and hypertension were associated with some independent changes in biochemical markers, but these were clinically negligible.</p><h3>Conclusion</h3><p dir="ltr">Our findings suggest that Ramadan fasting (fully or partially) is tolerable by hemodialysis patients and is not associated with important clinical complications. However, these patients should be made aware of the potential risk of fluid overload and hyperkalemia, if they decide to fast during Ramadan. Thus, they should be closely monitored and instructed to adhere to their dietary and fluid intake allowances. Further prospective cohort studies with comprehensive dietary measures and information on adverse clinical outcomes may provide more evidence about the tolerability and safety of Ramadan fasting by hemodialysis patients.</p><h2>Other Information</h2><p dir="ltr">Published in: PLOS ONE<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1371/journal.pone.0218745" target="_blank">https://dx.doi.org/10.1371/journal.pone.0218745</a></p>
eu_rights_str_mv openAccess
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identifier_str_mv 10.1371/journal.pone.0218745
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/25348285
publishDate 2019
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spelling The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort studyEmad Khazneh (4901830)Jamal Qaddumi (4745448)Zakaria Hamdan (6871712)Falasteen Qudaimat (6871715)Asmaa Sbitany (6871718)Kamel Jebrin (6871721)Osama Sawalmeh (6871724)Yousef Abuiram (6871727)Mujahed Shraim (633498)Biomedical and clinical sciencesClinical sciencesMedical dialysisDiabetes mellitusAdverse eventsCohort studiesCreatinineDietEducational attainmentMedical risk factors<h3>Background</h3><p dir="ltr">Ramadan fasting is compulsory for all healthy adult Muslims. Although sick people are exempted from Ramadan fasting, some patients such as hemodialysis patients prefer to fast during Ramadan. The effect of Ramadan fasting on clinical outcomes and biochemical markers among hemodialysis patients is not clear. The aim of this study was to examine the effects of daily Ramadan fasting and partial Ramadan fasting on key biochemical and clinical markers among hemodialysis patients as compared to hemodialysis patients who chose not to fast during Ramadan.</p><h3>Methods</h3><p dir="ltr">A prospective cohort study of 269 end stage renal disease patients were recruited from the hemodialysis unit in An-Najah National University Hospital, Nablus, Palestine. The participants were divided into three cohorts based on their plans for fasting during Ramadan in May 2018; Ramadan fasting group (RFG), Ramadan partial fasting group (RPFG) and Ramadan not-fasting group (RNFG). Key clinical and biochemical markers were measured before, during and after Ramadan.</p><h3>Results</h3><p dir="ltr">After adjustment for diabetic and hypertension status and other sociodemographic variables, RFG had higher mean inter-dialytic weight gain (IDWG) by 0.62 kg than RNFG (95% confidence interval (CI) 0.26, 0.99). RPFG also had slight increase in mean IDWG than RNFG by 0.35 kg (95% CI 0.11, 0.60). Additionally, RFG and RPFG had significant increase in mean serum potassium as compared to RNFG. Diabetes was independently associated with increased IDWG by 0.48 kg (0.25, 0.72). Diabetes and hypertension were associated with some independent changes in biochemical markers, but these were clinically negligible.</p><h3>Conclusion</h3><p dir="ltr">Our findings suggest that Ramadan fasting (fully or partially) is tolerable by hemodialysis patients and is not associated with important clinical complications. However, these patients should be made aware of the potential risk of fluid overload and hyperkalemia, if they decide to fast during Ramadan. Thus, they should be closely monitored and instructed to adhere to their dietary and fluid intake allowances. Further prospective cohort studies with comprehensive dietary measures and information on adverse clinical outcomes may provide more evidence about the tolerability and safety of Ramadan fasting by hemodialysis patients.</p><h2>Other Information</h2><p dir="ltr">Published in: PLOS ONE<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1371/journal.pone.0218745" target="_blank">https://dx.doi.org/10.1371/journal.pone.0218745</a></p>2019-06-24T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1371/journal.pone.0218745https://figshare.com/articles/journal_contribution/The_effects_of_Ramadan_fasting_on_clinical_and_biochemical_markers_among_hemodialysis_patients_A_prospective_cohort_study/25348285CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/253482852019-06-24T03:00:00Z
spellingShingle The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
Emad Khazneh (4901830)
Biomedical and clinical sciences
Clinical sciences
Medical dialysis
Diabetes mellitus
Adverse events
Cohort studies
Creatinine
Diet
Educational attainment
Medical risk factors
status_str publishedVersion
title The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
title_full The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
title_fullStr The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
title_full_unstemmed The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
title_short The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
title_sort The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study
topic Biomedical and clinical sciences
Clinical sciences
Medical dialysis
Diabetes mellitus
Adverse events
Cohort studies
Creatinine
Diet
Educational attainment
Medical risk factors