Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients: A Prospective Cohort Study

Published on Mar 1, 2020in Journal of Renal Nutrition2.75
· DOI :10.1053/J.JRN.2019.06.003
Nurul Iman Hafizah Adanan1
Estimated H-index: 1
(UPM: Universiti Putra Malaysia),
Mohamad Syafiq Md Ali1
Estimated H-index: 1
(UPM: Universiti Putra Malaysia)
+ 6 AuthorsZulfitri Azuan Mat Daud5
Estimated H-index: 5
(UPM: Universiti Putra Malaysia)
Objective Studies investigating the health effects of prolonged intermittent fasting during Ramadan among Muslim patients on hemodialysis (HD) are limited and reported heterogeneous findings. This study aimed to evaluate the effects of intermittent fasting during Ramadan on nutritional and functional status of patients on maintenance HD. Design and Methods This was a 12-week, multicenter, prospective observational study. The study setting included three HD centers. Adult Muslim patients, who were undergoing HD session thrice weekly and planned to fast during Ramadan, were screened for eligibility and recruited. Nutritional and functional status assessments were carried out 2 weeks before (V0), at the fourth week of Ramadan (V1), and 4 weeks after Ramadan (V2). Nutritional status parameters included anthropometry (body mass index, interdialytic weight gain, waist circumference), body composition (mid-arm circumference, triceps skinfold, body fat percentage), blood biochemistry (albumin, renal profile, lipid profile, and inflammatory markers), blood pressure, dietary intake, and handgrip strength. Changes in nutritional and functional status parameters across study timepoints were analyzed using repeated-measures analysis of variance. Results A total of 87 patients completed the study, with 68 patients (78.2%) reporting fasting ≥20 days. Ramadan fasting led to significant reductions (all P   .05). Significant improvement was observed in serum phosphate levels, but serum albumin, urea, and creatinine were also reduced significantly during Ramadan (P  Conclusion Intermittent Ramadan fasting leads to temporary changes in nutritional status parameters and poses nondetrimental nutritional risk for patients on maintenance HD.
  • References (54)
  • Citations (4)
📖 Papers frequently viewed together
1 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Zakari Ali (University for Development Studies)H-Index: 3
#2Abdul-Razak Abizari (University for Development Studies)H-Index: 7
Background Ramadan is a monthlong fast for healthy adolescents and adult Muslims. The quality of foods eaten and eating patterns in Ramadan may be different from other months of the year. Food intake of adolescents is a concern as energy and nutrient requirements are higher and needed to support the growth spurt of this stage. The objective of the present study was to describe the food patterns, dietary diversity and body weight changes among adolescents during Ramadan.
5 CitationsSource
#1Pierre Delanaye (University of Liège)H-Index: 36
#2Kevin Quinonez (University of Liège)H-Index: 2
Last. Olivier Bruyère (University of Liège)H-Index: 58
view all 5 authors...
Background: Hand grip strength (HGS) is a key measurement in the assessment of frailty phenotype in haemodialysis patients. However, the measurement is not very standardized, and notably, current data on the potential impact of a haemodialysis session on the results are both limited and controversial. In the present analysis, we compared HGS results before and after a haemodialysis session in 101 patients. Methods: In the current observational study, HGS has been measured in adult haemodialysis ...
2 CitationsSource
#1Sharmela Sahathevan (UKM: National University of Malaysia)H-Index: 5
#2Chee-Hee Se (UKM: National University of Malaysia)H-Index: 2
Last. Tilakavati Karupaiah (Taylors University)H-Index: 12
view all 10 authors...
Summary Background and aims Poor dietary intake is commonly associated with malnutrition in the dialysis population and oral nutritional supplementation is strategized to redress dietary inadequacy. Knowledge on clinical efficacy of whey protein supplementation (WPS) as an option to treat malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients is limited. Methods This multicenter, parallel, open-label, randomized controlled trial investigated the clinical efficacy of WPS in 126...
2 CitationsSource
#1Ghazal KamranH-Index: 1
1 CitationsSource
#1Salem A BeshyahH-Index: 8
#2Issam M Hajjaji (University of Tripoli)H-Index: 2
Last. Abdul A. Shlebak (Imperial College Healthcare)H-Index: 2
view all 8 authors...
Ramadan fasting is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslims with medical conditions still choose to fast. This may adversely affect their health if not addressed properly. Recently, there has been an increased interest in the health implications of Ramadan fasting. The authors performed a narrative, nonsystematic review of the literature including case reports, case series, and review articles indexed in PubMed and Google Scholar in a full c...
3 CitationsSource
#1Jun Yang Lee (Monash University)H-Index: 4
#2Chee Piau Wong (Monash University Malaysia Campus)H-Index: 9
Last. Shaun Wen Huey Lee (Monash University)H-Index: 16
view all 5 authors...
Objective We evaluated the beliefs, experience and diabetes management strategies of type 2 diabetes mellitus (T2DM) Muslim patients that chose to fast during Ramadan. Research design and methods A semistructured focus group interview was conducted with 53 participants with T2DM. Participants were purposefully sampled and asked to share their perspective on Ramadan fasting. All interviews were audio recorded, transcribed verbatim and analyzed thematically. Results Participants reported optimism ...
8 CitationsSource
#1Karin J.R. IpemaH-Index: 4
#2Johanna Kuipers (UG: University of Groningen)H-Index: 9
Last. Casper F. M. FranssenH-Index: 26
view all 7 authors...
Background/Aims: Higher interdialytic weight gain (IDWG) is associated with higher predialysis blood pressure and increased mortality. IDWG is also increasingly being recognized as an indicator of nutritional status. We studied in detail the associations of various patient factors and nutritional parameters with IDWG. Methods: We collected data during one week for IDWG and hemodynamic parameters in 138 prevalent adult haemodialysis patients on a thrice-weekly haemodialysis schedule. A multivaria...
5 CitationsSource
#1Salman ImtiazH-Index: 3
#2Beena SalmanH-Index: 2
Last. Aasim AhmadH-Index: 7
view all 6 authors...
Introduction. Month of Ramadan bring many changes in life style, especially the diet of Muslims all over the world among both fasting and nonfasting individuals. Hemodialysis patients are kept on restricted diet because of fluid and electrolytes imbalance. The aim of this study was to compare changes in the clinical and biochemical parameters in fasting and nonfasting hemodialysis patients during the Ramadan. Materials and Methods. In a longitudinal study, we recruited 282 patients who were on m...
4 Citations
#1S.Z. TabeiH-Index: 10
#2Nooshin ZareiH-Index: 3
Last. Hassan JoulaeiH-Index: 10
view all 3 authors...
Context: The impact of spirituality on recovery from disease and the promotion of health is a topic that has received the attention of many researchers and scholars around the world. Spirituality is considered one of the natural capacities of humans that has positive effects on individuals’ health. The aim of this study was to review the impact of spirituality on people’s health and to discuss the relationship between health and belief in spiritual powers. Evidence Acquisition: This study compri...
8 CitationsSource
#1Shaikha Alshamsi (King Abdulaziz Medical City)H-Index: 1
#2Fatima Binsaleh (King Saud bin Abdulaziz University for Health Sciences)H-Index: 1
Last. Abdulla Al Sayyari (King Saud bin Abdulaziz University for Health Sciences)H-Index: 7
view all 11 authors...
This paper aimed to study the effect of Ramadan fasting on biochemical and clinical parameters and compliance for dialysis. A prospective multicenter observational cross-sectional study comparing fasting with a non-fasting stable adult hemodialysis patients for demographic and biochemical parameters, compliance with dialysis, inter-dialytic weight gain, pre- and post-blood pressure, and frequency of intradialytic hypotensive episodes was carried out. Six hundred thirty-five patients, of whom 64....
4 CitationsSource
Cited By4
Last. Pramod KhoslaH-Index: 10
view all 12 authors...
A rapid and reliable tool appropriate to quantifying macronutrient and micronutrient intakes in diets consumed by Malaysian hemodialysis (HD) patients is lacking. We aimed to develop and validate a novel HD-food frequency questionnaire (HD-FFQ) to assess habitual nutritional intakes of HD patients with diverse ethnic backgrounds. This study was conducted in three phases. In Phase I, a HD-FFQ comprising 118 food items was developed using 3-day diet recalls (3DDR) from 388 HD patients. Phase II wa...
#1Kamyar Kalantar-Zadeh (UCI: University of California, Irvine)H-Index: 100
#2Linda W. MooreH-Index: 17
#1Shahzaib Ahmad (St Helier Hospital)H-Index: 1
#2Tahseen A Chowdhury (Royal London Hospital)H-Index: 15
Chronic kidney disease (CKD) is common among Muslim patients, and many such patients are keen to fast during the month of Ramadan. Fasting for prolonged periods may be deleterious for patients with...
1 CitationsSource
#1Bayan Tashkandi (WSU: Wayne State University)
#2Deepinder Kaur (WSU: Wayne State University)H-Index: 2
Last. Pramod Khosla (WSU: Wayne State University)H-Index: 10
view all 9 authors...
The period of Ramadan (R) is associated with dramatic changes in eating habits involving extended periods of fasting on a daily basis. The current study assessed whether lipids and lipoproteins were impacted during R in chronic hemodialysis (HD) patients. Forty-five subjects in an outpatient dialysis clinic in Saudi Arabia were evaluated for anthropometric and lipid changes on a monthly basis before, during as well as one and two months after R. In addition to routine biochemical measures, anthr...