Relation Between Health-Care Medical Provider Opinion and Hemodialysis Patient Attitude Toward Fasting in Ramadan

Introduction: Muslim hemodialysis (HD) patients are motivated to practice fasting in Ramadan. Health-care providers may be unable to make a recommendation based on lack of evidence. The aim of the present study was to investigate patients’ and medical professionals’ opinion toward fasting in 4 HD centers in Egypt as well as the impact of physicians’ attitude on their patient behavior. Materials and Methods: This observational multicentric study was conducted on 161 patients undergoing HD and 23 physicians in 4 HD centers in Egypt just after Ramadan 1438 Hijri. Patients’ demographic characteristics as well as any associated comorbidities were recorded. Patients and physician were interviewed and were asked about their opinion toward fasting in HD patients and any experienced complications during fasting. Results: Eighty-one (50.3%) patients of the studied HD patients practiced fasting in Ramadan. No statistical difference was observed between fasting and nonfasting groups regarding age, gender, and duration of HD. Eighty percent of patients reported no complications. Fifteen (65.2%) physicians support the opinion that HD patients are capable to fast with precautions. There was a significant variation in fasting frequency among HD patients in the studied centers with a significantly low fasting frequency observed in the third center (10.5%). Most physicians from this HD center adopted that HD patients should not fast. Conclusion: HD patients were keen to practice fasting in Ramadan and were to a considerable extent capable of completing this Islamic worship. Patient decision seems to be affected by their physician’s opinion. Absence of clear recommendations to guide fasting in Ramadan in HD patients as in diabetic patients makes permission or prohibition of such practice unjustified.