Total abstention from food and water from sunrise to sunset during the month of Ramadan, is practiced by hundreds of millions of Muslims throughout the world. This pattern of fasting during Ramadan is different from the usual fasting as people are allowed to eat and drink between sunset and dawn but not after dawn. The amount and type of food (rich in protein, fat and sugar) eaten during the night may also be significantly different to that usually consumed during the rest of the year, while in other countries factors such as poverty ensure that the Ramadan fast results in a reduction in energy intake and a loss of body fat. Also, climate and duration of fasting differs from region to another. According to Islam, sick people are exempted from Fasting, but still a significant number of patients with various chronic diseases including chronic kidney diseases (CKD)insist on fasting in Ramadan due to their personal beliefs and physicians are facing this problem every year: What to advice their patients as there are no guidelines or protocols about who can and who cannot fast. In general no detrimental effects on health have been directly attributed to fasting during Ramadan. However caution is advised for moderate to severe CKD patients and the physicians should monitor their patients carefully during Ramadan in order to avoid any deleterious effects.
Effects of fasting during Ramadan on urinary excretion in Malaysian Muslims BY S. H. CHEAH', S. L. CH'NG2, R. HUSAIN' AND M. T. DUNCAN', British Journal of Nutrition (1990), 63, 329-337.
Research on Islamic fasting and health. Fereidoun Azizi, MD, Annals of Saudi Medicine, Vol 22, Nos 3-4, 2002.
Effect of Ramadan fasting on urinary risk factors for calculus formation. Amir Hossein Miladipour, et al , Iranian Journal of Kidney Diseases | Volume 6 | Number 1 | January 2012.
Effects of fasting in Ramadan on tropical Asiatic Moslems. Husain, R., Duncan, M. T., Cheah, S. H. & Ch’ng, S. L. British Journal of Nutrition 58, 4148., 1987.
Effects on health of fluid restriction during fasting in Ramadan .J.B Leiber et al, European Journal of Clinical Nutrition (2003) 57, Suppl 2, S30–S38.
Fasting Ramadan in Kidney Transplant Patients is Safe .Yousef Boobes et al, Saudi J Kidney Dis Transpl 2009;20(2):198-200.
Ramadan Fasting and Renal Transplant Recipients: Clinical and Biochemical Effects . Bassam Osman Bernieh, Saudi J Kidney Dis Transplant 1994;5(4):470-473.
The Effect of Ramadan Fasting and Physical Activity on Body Composition, Serum Osmolarity Levels and Some Parameters of Electrolytes in Females.Seyyed Reza Attarzadeh Hosseini et al , t J Endocrinol Metab. 2013 Spring; 11(2): 88–94.
Effects of Ramadan fasting and the values of hematological and biochemical parameters. El-Hazmi MAF, Al-Faleh FZ, Al-MoflehFA, Saudi Med J 1987;8:171-6.
Effects of Ramadan Fasting on Some Physiological and Biochemical Parameters in Healthy and Hypertensive Subjects in Aurangabad District of Maharashtra, India.Mohammed Salahudin et al . Journl of fasting and health Volume 2, Issue 1, Winter 2014, Page 7-13.
Food restriction, performance, biochemical, psychological, and endocrine changes in judo athletes. Degoutte F, Jouanel P et al Int J Sports Med.2006;27(1):9–18.
Ramadan fasting improves kidney functions and ameliorates oxidative stress in diabetic patients. El-Gendy O.A, Rokaya M, Hassan E, El-Batae H.E, Tawfeek S. World J Med Sci 2012:7(1):38-48.)
Effect of fasting Ramadan on body weight and some blood constituents of healthy Muslims. Sliman NA, Khatib FA. Nutr Rep Intern 1988;38:1299 -306.
The effect of fasting in Ramadan on patients with heart disease. Chamsi-Pasha H, Ahmed W.A ,Saudi Med J 2004:25(1):47-51.).
Dietary Fat, Blood cholesterol and Uric Acid Levels during Ramadan Fasting. - Nomani M , Int J Ramadan Fasting Res. 1997;1(1):1–6.
Serum glucose, bilirubin, calcium, phosphorus, protein and albumin concentrations during Ramadan. Azizi F. Rasouli HA. Med J Islamic Rep Iran 1987;1:38-41.
The effect of Muslim fast of Ramadan on routine laboratory investigation. Scott TG , King Abdulaziz Med J 1981;1:23-35.
Effect of fasting during Ramadan on water turnover in men living in the tropics. Leiper JB & Prastowo S-M (2000 J. Physiol. 528, 43 .
The effect of Ramadan fasting on some plasmatic and urinary parameters. Zebidi A et al. Tunisie Med. 1990 ,68, 367–372.
Auswirkungen eines periodischen Flüssigkeits- Born M, Elmadfa I & Schmahl FW (1979): und Nahrungsentzuges. Muench. med. Wschr. 121, 1569–1572.
Effect of Ramadan fasting on glucose, glycosylated haemoglobin, insulin, lipids and proteinous concentrations in women with non-insulin dependent diabetes mellitus. Saada A, et al African J Biotech. 2010;9(1):87–94.
Acid-base metabolism. In Clinical Disorders of Fluid and Electrolyte. Cohen, J. J. & Kassirer, J. P. (1980).Metabolism, 3rd ed, pp. 181-232.
Markers of hydration status. Shirreffs SM , Eur. J. Clin. Nutr. ;2003 Dec;57 Suppl 2:S6-9.
The effects of fasting in Ramadan. 2. Fluid and electrolyte balance. Mustafa KY et al . Br. J. Nutr.;1987; 40, 583–589.
The Impact of ramadan fasting on hydration status of type 2 diabetics in kubang kerian, Azwany N, Aziz A, Mohammad W. kelantan. J Kesihatan Masyarakat Zsu Khas. 2004;30-4.
Variation of biochemical parameters of the firstmorning urine during month of Ramadan. Zghal A et al, Tunis Med2005;83:591-4.
)