Fasting during Ramadan and three common kidney diseases: patients with a kidney transplant, renal failure and urolithiasis

Abstract

The aim of this study was to review and analyze the effects of fasting in Ramadan on the normal renal system and several common kidney diseases, including urinary stones, patients who have received a kidney transplant, and patients with kidney failure. Materials and Methods: In this study, with the help of an experienced librarian, basic search strategy was designed and used in PubMed, The Cochrane Library, Embase, Scopus, ProQuest, Google Scholar, Web of Sciences. The selected articles were thoroughly studied and the required information in the review section of the ¬mand system was extracted and summarized using the extraction table designed in the Excel environment of Microsoft Office 2007. The Endnote X5 Resource Management Software was used to organize, study titles and abstracts, as well as identify duplicate items. SPSS/ver16 software was also used to analyze quantitative data. Forest plot charts were used to report the results. Funnel plot was also used to assess the bias between publishing articles. Results: 3207 articles were identified in a systematic search of sources. 1382 articles were excluded due to duplication, and 443 articles were excluded after reviewing the title and reviewing the abstracts. After reviewing the full text of the articles, 1349 articles were excluded. Finally, 33 articles that met the entry criteria were included in this meta-analysis study. In 4 studies, the mean GFR for kidney transplant patients was reported before and after Ramadan. The mismatch between studies was significant (Q = 173.379, df = 3, I2 = 98.27, p-value <0.01). The results of meta-analysis showed that the difference between the standardized GFR before and after Ramadan for kidney transplant patients was -0.736 (SMD = -0.736, 95% CI: -1.8816 to 0.343; p-value = 0.181). In 9 studies, the mean GFR for CKD patients was reported before and after Ramadan. The mismatch between studies was significant (Q = 39.149, df = 8, I2 = 79.57, p-value <0.01). The results of meta-analysis showed that the difference between the standardized GFR before and after Ramadan for CKD patients was 0.137 (SMD = -0.137, 95% CI: -0.464 to 0.189; p-value = 0.409). Regarding the articles related to fasting and urinary stones, it was not possible to perform meta-analysis in the obtained articles.