Effect of Ramadan intermittent fasting on short-term heart rate variability among hemodialysis patients

Background In the general population, prior research has demonstrated the positive effects of fasting on the heart, where it is linked to a reduction in the risk factors for cardiovascular disease. Although hemodialysis (HD) patients are considered very high risk, some patients are highly motivated and insist on fasting. Limited data exists on the effect of Ramadan fasting on heart rate variability (HRV) a measure of cardiac autonomic function among maintenance HD patients. Patients and methods An observational longitudinal study of Ramadan fasting patients on maintenance HD. All participants underwent a 5 min Holter ECG recording at the end of the HD session during Ramadan 29 and 30, then another 5 min Holter ECG recording two months after Ramadan. Time and frequency domain HRV indices were analyzed. Results Among 95 HD patients assessed for eligibility, 53 practiced Ramadan fasting either daily or intermittently. Forty-seven patients met inclusion and exclusion criteria and underwent 5 min Holter ECG recordings twice. The mean age of participants was 47.77 years (±13.78) and 59.6% were males. Patients did not differ significantly about heart rate, frequency, and time domain measures ( P >0.05) during and two months after Ramadan. Conclusion Practicing Ramadan intermittent fasting does not impose a substantial risk to the cardiac autonomic nervous system function among maintenance HD patients, further research is required to confirm these findings.