Perceptions And Practices About Ramadan Fasting in Hemodialysis Patients

Background: Perceptions and practices of hemodialysis patients regarding Ramadan fasting remain a matter of debate in the Muslim world due to differing opinions and outcomes. Objective: To evaluate the perceptions and practices about Ramadan fasting in hemodialysis patients. Methodology: A cross-sectional study conducted among patients undergoing hemodialysis at a dialysis unit of Memon Medical Institute Hospital, Karachi, during Ramadan (March-April 2024). Patients undergoing regular hemodialysis sessions were selected and grouped based on their fasting status: complete fasting, partial fasting, and non-fasting. Demographic data, biochemical parameters, and 11 question themes (5 on perceptions and 6 on practices) were collected. Data were analyzed in SPSS version 25 using descriptive statistics, one-way ANOVA, and the chi-square test; p-values < 0.05 were considered significant. Results: A total of 179 patients were included (mean age of 51.39±16.23 years), among whom 3.93% were in the fasting group, 26.40% in the partial group, and 69.66% in the non-fasting group. Significant differences were observed in both perceptions and biochemical outcomes. 100% of fasting participants and 72.3% of partial fasting participants showed positive effects of fasting compared with only 29% of the non-fasting group (p=0.001). Adverse effects such as weakness and fatigue were reported by the majority in the non-fasting group (69.4%) compared with the partial fasting (21.3%) and fasting (42.9%) groups (p=0.001). Among biochemical parameters, only serum potassium levels differed significantly (p = 0.024), with higher levels in the fasting group. Conclusion: Fasting and partial fasting individuals were more likely to perceive beneficial effects, whereas non-fasting individuals were more likely to report adverse effects. These findings highlight the importance of individualized education and guidance regarding fasting practices.