Doha: Patients with kidney disease should take precaution if they choose to fast during Ramadan, Dr Hassan Al Malki, (pictured) Nephrology and Transplant Senior Consultant, Hamad Medical Corporation (HMC), has advised.
Chronic kidney disease (CKD), which can be categorised into five stages based on severity, affects about 13 percent of the country’s population.
“The category of a patient’s kidney disease severity can indicate if he/she will be able to fast or not.
“For instance, patients with acute kidney failure should not fast until they fully recover. However, CKD patients have different stages of nephropathy (kidney disease), and those diagnosed with stage three CKD or higher are advised not to fast as their kidneys fail to retain normal rates of body fluids, making them susceptible to further renal dysfunction and damage,” he cautioned.
Dr Al Malki stressed that since abstention from food and water for long hours can lead to dehydration, CKD patients should consult their physician to assess the severity of their condition and the potential risks associated with fasting.
“Hemodialysis (a type of renal replacement therapy) patients typically undergo dialysis three times per week and cannot fast due to IV fluid intake during the procedure; however, they can fast during the rest of the week days,” Dr. Al Malki added.
He also advised kidney transplant patients not to fast as they must comply with prescribed medication dosages and times. As many such patients are diabetic, fasting may have a negative impact on their health so it is imperative that they consult their physician before they decide to fast.
Ayman Alawneh, HMC Dietitian, said kidney disease patients should consult their dietitian to ensure adequate protection against potential complications of fasting.
He said many patients tend to overlook maintaining a healthy and balanced diet while fasting.
“Kidney disease patients should not skip Sahoor to avoid weakness, bearing in mind that they need more calories than people in good health.
“Patients should be on their guard not to ingest high quantities of sodium, potassium and phosphorus, especially during Ramadan. Sodium is abundantly contained in table salt, and potassium in some vegetables such as tomatoes, potatoes, okra, and green leafy vegetables as well as fruits, including bananas, oranges, mangoes, dates, apricots, peaches and cantaloupe. Phosphorus is found in beans, carbonated drinks, nuts and dairy products,” he said.
He stressed that patients who are on phosphorus lowering medications should take pills during and not before or after meals.
According to him, each kidney disease has its dietary requirement for Ramadan.
“If physicians approve fasting for pre-dialysis kidney patients, they should maintain a diet low in protein-rich food to avoid imposing extra burden on their kidneys that could lead to renal failure and increase urea in their system,” he advised.
“On the contrary, dialysis patients need to increase their protein intake, especially animal proteins, to compensate for the proteins lost in the dialysis process.”
“Pre-dialysis kidney patients should drink two to three litres of fluid per day if the volume of urine they pass is within the normal rate.
“Otherwise they should reduce their fluid intake to avoid water retention that could affect the heart and lungs,” he advised.
“Hemodialysis patients should be careful not to drink more than one litre of water/fluid daily after Iftar to prevent water retention that would otherwise affect their heart and lungs.
“Peritoneal dialysis patients can drink up to two litres of water daily, depending on the amount of fluid discarded in the dialysis process,” said Alawneh.
“They should be aware of the quantities of fluid they consume and reduce their intake of sweets and fatty foods as they are more prone to cardiovascular diseases,” he said.
He also advised kidney disease patients to avoid high temperatures when they are fasting and avoid salty foods.
HMC is urging patients with kidney disease who experience any difficulties while fasting to seek urgent professional advice or dial 999 for Ambulance Service.
The Peninsula
