Kirubarajan Abirami, Lam Andrew C L, Khan Shawn, Yau Matthew, Golda Nicole, Buckley Roger
Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Can Urol Assoc J. 2021 Mar;15(3):E169-E174. doi: 10.5489/cuaj.6664.
Fasting is a common cultural practice worldwide for both religious and dietary reasons. However, there is concern that fasting may be a risk factor for the development of renal stones. To date, there has not been a systematic assessment of the literature regarding the association between renal stones and fasting.
We conducted a systematic review following PRISMA guidelines of three databases: Medline-OVID, EMBASE, and CINAHL. All screening and extraction was completed in parallel with two independent reviewers.
Of the 1501 database citations, a total of 10 observational studies with a total of 9906 participants were included. Nine of the studies were conducted in the context of Islamic fasting during Ramadan, with the majority (7/9) finding that renal colic incidence was unaffected by the month of fasting. In contrast, two studies noted an increased incidence among fasting populations. Two other studies noted that urine metabolites and density were altered with fasting but did not translate into clinical outcomes.
Based on the available evidence, it is unlikely that fasting significantly increases the risk of renal stones. Physicians should counsel higher-risk patients on safe fasting practices.
出于宗教和饮食原因，禁食在全球都是一种常见的文化习俗。然而，人们担心禁食可能是肾结石形成的一个风险因素。迄今为止，尚未对有关肾结石与禁食之间关联的文献进行系统评估。
我们按照PRISMA指南对三个数据库进行了系统综述：Medline - OVID、EMBASE和CINAHL。所有筛选和提取工作由两名独立评审员并行完成。
在1501条数据库引用中，共纳入了10项观察性研究，总计9906名参与者。其中9项研究是在斋月期间伊斯兰教禁食的背景下进行的，大多数研究（7/9）发现肾绞痛发病率不受禁食月份的影响。相比之下，有两项研究指出禁食人群中的发病率有所增加。另外两项研究指出，禁食会改变尿液代谢产物和密度，但未转化为临床结果。
根据现有证据，禁食不太可能显著增加患肾结石的风险。医生应就安全的禁食做法向高危患者提供咨询。
