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Kidney Week

Abstract: PO0206

AKI in the Month of Ramadan

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • AlSahow, Ali, Al Jahra Hospital, Al Jahra, Al Jahra, Kuwait
  • Alkandari, Omar M.A.A., Mubarak Al-Kabeer Hospital, Safat, Kuwait
  • Al Yousef, Anas M., Amiri Hospital, Kuwait City, Kuwait, Kuwait
  • Alhelal, Bassam A., Al Adan Hospital, Kuwait, Al Asimah, Kuwait
  • Al Rajab, Heba, Farwaniya Hospital, Farwaniya, Farwaniya, Kuwait
  • Said, Basem, Al Jahra Hospital, Al Jahra, Al Jahra, Kuwait
  • Mazroue, Ahmed Mohamed, Amiri Hospital, Kuwait City, Kuwait, Kuwait
  • Osman, Mohamed Abdellatif, Farwaniya Hospital, Farwaniya, Farwaniya, Kuwait
  • Elhusseini, Zeyad Abdelgawad, Al Adan Hospital, Kuwait, Al Asimah, Kuwait
Background

Fasting in Ramadan from dawn to sunset is one of Islam's 5 pillars. Islamic lunar calendar is 11 days shorter than Gregorian solar calendar, so the start of Ramadan changes every year and hours spent on fasting vary from 12 hours in Australia, to 21 hours in Sweden, with most countries have 11-16 hours of fasting on average. Patients with certain medical illness are exempted from fasting, however, many such patients partake in fasting. The long hours of fasting may be a risk factor for AKI in certain populations. We assess AKI in Ramadan.

Methods

Demographics, comorbidities, treatment, and 4 weeks outcome data for all nephrology consultation for AKI in 4 public hospitals in Kuwait during Ramadan of 2021 (13/April-12/May/2021) prospectively collected and analyzed. We compare AKI in people fasting prior to admission to non-fasting.

Results

Total number of AKI cases in Ramadan was 158, 55% males, mean age 64, and 61% were Kuwaiti citizens. Community acquire cases were 15%. DM affected 75%, HTN 72%, and cardiac disease 25% of patients. Median baseline eGFR before AKI was 66.5. Baseline eGFR < 60 seen in 43%, and those compared to patients with eGFR > 60, had median baseline eGFR of 37.5 (vs 92), were older (69 vs 62), 87% had DM (vs 66%) and 87% had HTN (vs 61%). Cause of AKI was pre-renal / ischemic ATN in 69%, COVID-19 related in 17%. Many had more than one possible cause. IV fluids used in 76%, IV diuretics in 39%, IV vasopressors in 31%, and steroids in 21.5%. KRT needed in 27%. Volume overload and electrolytes / acid-base disorders were most common indication (21% and 19% respectively and 15% had more than one indication. Death within 30 days occurred in 11.4%. Of the total, 24% were fasting before admission, with mean age of 56 (compared to 63 for non-fasting). No significant difference in baseline eGFR between fasting and non-fasting, nor in use of IV fluids, IV diuretics, or IV vasopressors. Dialysis needed in 21% of the fasting group, not significantly different from non-fasting group. Mortality rates were lower but not statistically significant in the fasting group (8% vs 12.5%).

Conclusion

AKI affect both fasting and non-fasting population similarly, with no increased risk of need for dialysis or mortality.