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Mortality trend among hemodialysis patients during the islamic month of Ramadan: a 24 years retrospective study.

OBJECTIVE
The effect of month of Ramadan on the mortality in hemodialysis patients, and to compare it with that in all other Islamic months.


STUDY DESIGN
A descriptive study.


PLACE AND DURATION OF STUDY
Hemodialysis Unit, The Kidney Center, Karachi, from January 1989 to December 2012.


METHODOLOGY
All those patients who were diagnosed to have end stage kidney disease and on maintenance hemodialysis for more than 3 months, regardless of underlying cause of kidney failure were included. Patients with acute kidney injury were excluded. Status of the patients was recorded at the end of the study period. The fasting status of the patients was not mentioned. The deaths of the patients were further evaluated and frequencies of death in all twelve Islamic months were calculated.


RESULTS
A total of 1,841 patients were registered, out of whom 897 (48.7%) died, and 269 (14.6%) survived till the end of the study. One thousand and fifty six (57.3%) were males, 651 (35.4%) were diabetic. Total number of 143 (7.76%) events occurred in Ramadan, out of which 94 patients died which make nearly 11% of the total deaths distributed in 12 Islamic months. Frequency of death was higher in Ramadan when compared with other months.


CONCLUSION
Ramadan reflected a higher frequency of death. Therefore, there is a need to evaluate the risk factors in a prospective study so that the dialysis patients can be better managed during this period.