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The Impact of Ramadan Fast on Patients With Gout

Habib, George MD, MPH*†‡; Badarny, Samih MD†§; Khreish, Maroun MD; Khazin, Fadi MD; Shehadeh, Vivian RD#; Hakim, Geries MD**; Artul, Suheil MD††

JCR: Journal of Clinical Rheumatology: October 2014 - Volume 20 - Issue 7 - p 353–356
doi: 10.1097/RHU.0000000000000172
Original Articles
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Backgrounds Ramadan fast is a religious custom in Islam. Increased serum uric acid level during this month had been reported in past studies of nongout patients.

Objectives The objective of this study was to assess the impact of Ramadan fast on patients with gout.

Methods All Moslem patients with gout from the registry of Nazareth Hospital, who intended to fast during Ramadan, were asked to participate in our study (group 1). Data regarding age, gender, income, education, duration of gout, meds, adherence to low-purine diet, and gouty attacks were documented. Age- and gender matched Moslem patients from the same registry, but who did not intend to fast during Ramadan, were asked to participate as a control group (group 2). Just prior to and at the end of Ramadan, blood for uric acid, creatinine, and urea levels were obtained as well as body mass index, from all the patients. During Ramadan, patients were monitored for gouty arthritis or renal calculi attacks, as well as low-purine diet and medicine adherence.

Results Twenty-one and 22 patients from groups 1 and 2, respectively, completed the study. Mean serum uric acid, urea, creatinine, and body mass index levels at the end of Ramadan fasts in group 1 patients were 8.11 mg/dL, 26.38 mmol/L, 0.87 mg/dL, and 31.0 kg/m2, respectively, as compared with 7.92 mg/dL (P = 0.707), 24.54 mmol/L (P = 0.769), 0.84 mg/dL (P = 0.180), and 30.5 kg/m2 (P = 0.907) respectively, obtained just prior to the fast. No significant change in any parameter was seen also in group 2 patients. There also was no significant change between the 2 groups in arthritis or renal calculi attacks and also in medication and low-purine diet adherence, during Ramadan.

Conclusions There was no risk for a significant increase in gouty arthritic/renal calculi attacks or serum uric acid in patients with gout during Ramadan fast.

From the *Department of Medicine, Carmel Medical Center; and †Faculty of Medicine, Technion, Israel Institute of Technology, Haifa; and ‡Rheumatology Clinic, Nazareth Hospital, Nazareth; §Department of Neurology, ║Department of Medicine, Carmel Medical Center, and ¶Department of Orthopedics, Carmel Medical Center, Haifa; #Diet Unit, Carmel Medical Center; and Departments of **Orthopedics and ††Radiology, Nazareth Hospital, Nazareth, Bar-Ilan Medical School, Tzfat, Israel.

The authors declare no conflict of interest.

Correspondence: George Habib, MD, MPH, Department of Medicine, Carmel Medical Center, Haifa 34362, Israel. E-mail: gshabib@gmail.com.

© 2014 by Lippincott Williams & Wilkins, Inc.