Table 2.
Published studies in non-dialysis CKD patients
| Author | Year | CKD stages (non-dialysis) | No. of patients | Outcome measure | Result |
|---|---|---|---|---|---|
| Al Muhanna [11] | 1998 | Moderate to severe CKD, CrCl <35 mL/min | 36–18 males and 18 females | Change in renal function (CrCl) | CrCl pre-Ramadan 17.2 ± 3.5 mL/min, end of Ramadan 13.2 ± 2.2 mL/min and 2 weeks later 13.7 ± 3.2 mL/min |
| El-Wakil et al. [12] | 2007 | Mean GFR for study group 33.3 ± 21.1 mL/min; for controls 111.6 ± 21.3 mL/min | 12 (40% males) and 6 controls (100% males) | Change in GFR measured by technetium-99m DTPA and NAG | Change in GFR not statistically significant with −6.56 ± 31.1% change in CKD patients compared with 9.58 ± 30.1% in controls (p < 0.43). Although NAG was different between CKD and control group, there was no statistically significant difference in NAG within the CKD group pre- and post-Ramadan |
| Bernieh et al. [13] | 2010 | CKD Stages 3–5 | 31 (61.3% males) | CrCl (Cockcroft Gault), albumin, lipids, weight | CrCl increased post-Ramadan compared with pre-Ramadan. This could be explained by observed decease in body weight |
| Al-Wakeel [14] | 2014 | CKD Stages 3 and 4 (dialysis cohort excluded in this table) | 39 (23.1% males) | Change in renal function (CrCl) | No significant change noted. Potassium pre-Ramadan 4.8 ± 0.6 mmol/L, post-Ramadan 4.7 ± 0.5 mmol/L. CrCl pre-Ramadan 40.8 ± 25.4 mL/min and post-Ramadan 44 ± 29.3 mL/min |
| NasrAllah and Osman [15] | 2014 | CKD Stages 3–5 | 106: 52 fasting (32% males), 54 non-fasting (27% males) | Cardiovascular outcomes | In the fasting group, 6 adverse cardiovascular events occurred compared with 1 in the control group. All of those affected in the fasting group had an associated decrease in eGFR. The mean deviation in eGFR in the fasting group was −3% (SD 17.8) compared with ±1.3% (SD 24.5) in the non-fasting group |
| Mbarki et al. [16] | 2015 |
Mean CrCl 72.85 ± 40 mL/min Group 1: <60 mL/min (20 patients), Group 2: 30–59 mL/min (26 patients), Group 3: 15–29 mL/min (5 patients) |
60 (41.6% males) | Development of AKI (as defined by KDIGO criteria) | Seven patients met the criteria for AKI. In five there was full recovery and in two there was partial. Follow-up was 1 week post-Ramadan and findings were not statistically significant |
| AA Bakhit et al. [17] | 2017 |
CKD Stages 3–5 (36 CKD Stage 3, 24 CKD Stage 4, and 5 CKD Stage 5) |
65 (61.5% males) |
Change in renal function (eGFR by CKD-EPI) pre- and 3 months post-Ramadan |
Mean eGFR 31.1 ± 13.3 mL/min and SCr 206 ± 88 μmol/L, mean increase during Ramadan to 214 μmol/L and a decrease to 209 μmol/L RR of worsening of renal function: CKD Stage 3B 1.6 (95% CI 0.5–5.4), CKD Stage 4 3.6 (95% CI 1–13.9), CKD Stage 5 2.2 (95% CI 0.7–6.5) |
| Kara et al. [18] | 2017 | CKD Stages 3–4 | 45 fasting (31% male) and 49 non-fasting (25% male) | Change in renal function (eGFR) | No difference within group or between groups |
| Ekinci et al. [19] | 2018 | CKD Stages 1–2 with ADPKD | 23 fasting (17.4% males) and 31 non-fasting (41.9% males) | Change in eGFR, electrolytes, KIM-1 and NGAL | No statistically significant difference in any of the observed measures |
| Hassan et al. [20] | 2018 | CKD Stages 2–4 | 31 fasting (54.8% males) and 26 non-fasting (53.8% males) | Change in eGFR | No significant difference found |
| Alawadi et al. [21] | 2019 | CKD Stage 3 | 19 (57.8% males) | Glucose level, change in blood pressure, HbA1c, renal function (eGFR) and BMI | No significant change found |
| Chowdhury et al. [22] | 2019 | CKD Stage 3 | 68 fasting (51.4% males) and 71 non-fasting (49.2% males) | Change in renal function (eGFR by MDRD) and urine PCR | No significant differences in biochemical parameters |
| Mahmoud and Barakat [23] | 2019 | CKD Stages 3–4 | 20 (60% females) | Renal function (eGFR by CKD- EPI) fatigue, mood and cognition | No change in renal function. However, fatigue, mood and cognition were worse when measured after Ramadan |
| Baloglu et al. [24] | 2020 | CKD Stages 2–3 | 117 (69.2% males) | Development of AKI (as defined by KDIGO criteria) | 27 developed AKI, history of hypertension was associated with AKI, unclear if AKI resolved and whether patients were on RAAS inhibitors or diuretics |
| Eldeeb et al. [25] | 2020 | CKD Stages 3–4 | 34 (58.8% females) and 37 controls (59.5% females) | Renal function (eGFR by CKD- EPI) central and brachial blood pressures | Improved central and brachial blood pressures, weight and creatinine were lower post-Ramadan |
ADPKD, autosomal dominant polycystic kidney disease; BMI, body mass index; CKD-EPI, Chronic Kidney Disease Epidemiology Collaboration; CrCl, creatinine clearance; DTPA, diethylenetriaminepentaacetic acid; HbA1c, haemoglobin A1c; KDIGO, Kidney Diease: Improving Global Outcomes; KIM-1, kidney injury molecule 1; MDRD, Modification of Diet in Renal Disease; NAG, N-acetyl-D-glucosaminidase; NGAL, neutrophil gelatinase-associated lipocalin; PCR, protein:creatinine ratio; RAAS, renin–angiotensin–aldosterone system.