Haroon Anita, Riaz Musarrat, Rabbani Bushra, Saeed Ammarah
Dr. Anita Haroon, MRCP , FCPS (Nephrology), FRCP Assistant Professor, Department of Nephrology, Baqai Medical University, Karachi, Pakistan.
Dr. Musarrat Riaz, FCPS (Med), FCPS (Endocrinology). Associate Professor, Department of Medicine, Baqai Medical University, Karachi, Pakistan.
Pak J Med Sci. 2024 Mar-Apr;40(4):563-567. doi: 10.12669/pjms.40.4.7989.
To assess the safety of fasting in diabetic and non-diabetic patients with stable CKD during Ramadan.
This prospective observational study was conducted at three secondary and tertiary care hospitals of Karachi during the month of Ramadan from 25 March to 7 May 2022. Patients who met the eligibility criteria were assessed pre-Ramadan, and their baseline blood pressure, serum urea, creatinine, electrolytes, uric acid, and estimated glomerular filtration rate (eGFR) were documented and tracked over the course of Ramadan and up to one week post-Ramadan. Deterioration in renal functions (defined as a rise of ≥30% in serum creatinine from the baseline or the decline of ≥25% in eGFR from the baseline) was observed during the month of Ramadan.
A total of 68 patients (34 males and 32 females) with the mean age 58.7±12.16 years were included in the study. Out of 66 patients, 38 were diabetic and 28 were non diabetic. Majority 23(34.8%) were stage-3a and 23(34.8%) were stage-4 followed by stage-3b in 14(21.2%), stage-2 in 3(4.5%) and stage-5 in 3(4.5%) patients respectively. Statistically significant improvement in pre and post Ramadan values of systolic and diastolic blood pressure, serum creatinine and uric acid levels were found in both diabetic and non-diabetic group (P value <0.0001).
Our study shows no worsening of renal functions in both diabetic and non-diabetic patients with stable CKD who intended to fast.
评估斋月期间稳定期慢性肾脏病(CKD)的糖尿病和非糖尿病患者禁食的安全性。
这项前瞻性观察性研究于2022年3月25日至5月7日斋月期间在卡拉奇的三家二级和三级医疗机构进行。符合纳入标准的患者在斋月前接受评估,记录其基线血压、血清尿素、肌酐、电解质、尿酸和估计肾小球滤过率(eGFR),并在斋月期间及斋月后一周进行跟踪。观察斋月期间肾功能的恶化情况(定义为血清肌酐较基线升高≥30%或eGFR较基线下降≥25%)。
共有68例患者(34例男性和32例女性)纳入研究,平均年龄58.7±12.16岁。66例患者中,38例为糖尿病患者,28例为非糖尿病患者。大多数患者中,23例(34.8%)为3a期,23例(34.8%)为4期,其次是14例(21.2%)为3b期,3例(4.5%)为2期,3例(4.5%)为5期。糖尿病组和非糖尿病组的收缩压和舒张压、血清肌酐和尿酸水平在斋月前后的值均有统计学意义的改善(P值<0.0001)。
我们的研究表明,计划禁食的稳定期CKD糖尿病和非糖尿病患者的肾功能均未恶化。