The effect of ramadhan fasting on kidney function among elderly patients

During the Ramadhan month, every Moslem is expected to abstain from eating and drinking between dawn to sunset, averaging 15 hours daily. Regardless of their declining functional capacity, changes in body homeostasis, diminished thirst sensation and multiorgan insufficiency, elderly people in Indonesia still have great motivation to do fasting. Diminished sensation of thirst will put them in difficult and possibly harmful situation, particularly dehydration which can lead to further declining of kidney function. Prospective self-controlled study was conducted in outpatient geriatric clinic, Cipto Mangunkusumo National Hospital, Jakarta, to evaluate the effect of Ramadhan fasting on kidney function in elderly patients. Forty two elderly people, aged 60 years or more with creatinine clearance (CCT) of ≥25 ml/minute were recruited in this study. Kidney function manifested by CCT was examined 5 times: 7 day before fasting; day-7, 17 and 28 of Ramadhan fasting; and 14 days after fasting. Kidney function significantly declined on the 7th and 17th day of Ramadhan without apparent clinical deterioration. However, on the 28th day, kidney function improved. Even, 14 days after Ramadhan, improvement of kidney function was evident. Clinical classification based on CCT level (<20; 20-30; 30-50, and >50 ml/minute) showed a tendency of improvement during fasting.