#4971 IMPACT OF RAMADAN FASTING ON NUTRITION, INFLAMMATION AND DIALYSIS ADEQUACY AMONG HEMODIALYSIS PATIENTS

Abstract

Abstract Background and Aims There is a paucity of data concerning safety of fasting in Ramadan in End stage kidney disease patients (ESKD) on haemodialysis (HD). The aim of the present study was to assess the possible effect of fasting on nutritional status (clinical, biochemical variables), inflammatory status and adequacy of haemodialysis. This observational study was carried out during 2022 when fasting duration was around 14 hours. Method Sixty-five patients suffered from ESKD who received regular HD for more than six months in dialysis unit, urology and nephrology center Mansoura university were included in this prospective observational study. Patients were categorized into three groups. 21 patients fasted all days of Ramadan,25 patients fasted days other than session days and 19 patients never. We did not oblige our patient to fast. nutritional status was assessed clinically by Anthropometric measurements including body weight, BMI, triceps skin fold thickness (TSF) and estimation of protein catabolic rate (PCR) were measured, and laboratory by serum Albumin, cholesterol and fasting blood glucose. Neutrophils to lymphocytes ratio (NLR), Soluble receptor of advanced glycation end product(SRAGE) and human B-cell lymphoma/leukemia2 (BCL2) was measured as inflammatory markers, also dialysis adequacy was determined with urea reduction ratio (URR) and KT/V. Assessment of all patients were carried out before and after Ramadan month and was repeated 3 months after Ramadan in all patients. Results In 30 days fasting group: there was significant reductions (all P < .02), serum albumin, triceps skin fold thickness, Subjective global assessment score (SGA) for nutritional assessment also in inflammatory markers as neutrophils to lymphocytes ratio (NLR) and human Bcell lymphoma/leukemia2 (BCL2). But these were not accompanied by any significant change (all P >0.05) in body mass index, serum cholesterol, fasting blood sugar (FBS), urea reduction ratio (URR), intradialytic weight gains (IDWG), Kt/V and human soluble receptor for advanced glycation end products (sRAGEs). In the group Who was reported fasting in days other than HD session days: fasting led to significant reductions (all P < .02) only in serum albumin and triceps skin fold thickness. There were no significant changes in BMI, URR, Cholesterol, FBS, KT/V, IDWG, SGA score, NLR, sRAGEs and BCL2. In patients Who never fast at all: there was significant reduction (all P<0.02) in triceps skin fold thickness, significant change in SGA score and also in sRAGEs and BCL2. Conclusion There was no harmful effect for Muslim patients receiving regular HD who want to fast Ramadan in days other than HD session days. In the current study the fasting group has the benefit of both being fasting and non-significant changes in mostly all nutritional assessment points, inflammatory markers and the adequacy of HD.