POS-163 AKI IN RAMADAN: A PROSPECTIVE OBSERVATIONAL MULTI-CENTER STUDY

ABSTRACT

Introduction: Fasting during Ramadan from dawn to sunset is one of the 5 pillars of Islam. Islamic lunar calendar is 11 days shorter than the 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. 1,2The long hours of fasting may be a risk factor for AKI in certain populations. We assess AKI in Ramadan of 2021, where the weather was moderately hot. Methods: Demographics, comorbidities, treatment, and 4 weeks outcome data for all nephrology consultation for AKI in four public hospitals in Kuwait during Ramadan of 2021 (13/April to 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 during 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 AKI cases, 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 in the fasting group but not statistically significant (8% vs 12.5%). Conclusions: AKI affect both fasting and non-fasting population similarly, with no increased risk of need for dialysis or mortality. Conflict of interest Potential conflict of interest This has been accepted for ASN Kidney Week 2021 ( Number 3600035 )