Safety and Clinical Outcomes of Ramadan Fasting in Patients with Arginine Vasopressin Deficiency: A Retrospective Cohort Study
https://doi.org/10.15605/jafes.041.S1
- Author:
Suprhamanyam Evali
1
;
Nur Arina binti Mohammed Zain
1
;
Nao Chang Zhao
1
;
Noor Ashikin binti Ismail
1
;
Dineash Kumar Kannesan
1
;
Nurain binti Mohd Noor
1
Author Information
1. Endocrine Unit, Hospital Putrajaya
- Publication Type:Journal Article
- MeSH:
Humans;
Diabetes Insipidus, Neurogenic;
Retrospective Studies;
Arginine;
Fasting
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):80-81
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Arginine vasopressin deficiency (AVP-D) is characterized
by impaired antidiuretic hormone secretion, leading to
polyuria and a significant dehydration risk. The British
Islamic Medical Association classifies AVP-D as a “very
high risk” condition, advising against Ramadan fasting. However, many patients fast due to religious convictions,
creating a gap between clinical guidelines and patient
practice. This study evaluates the clinical outcomes and
safety of fasting in this population.
Methodology:A single-centre retrospective cohort study was conducted
at Hospital Putrajaya. We included adults with
permanent AVP-D on desmopressin therapy for more
than 1 year who fasted during Ramadan 2025. Data were
extracted from electronic medical records and patient
consultations. Primary outcomes included hospitalization
rates, dehydration symptoms, and desmopressin dose
adjustments.
Results:Of the 43 patients (mean age 42.4 ± 15.28 years; 53.5%
female), 27 successfully fasted for a mean of 27.6 ± 6.56
days. Pre-Ramadan counseling was documented in only
55.8% of cases. While 25.9% of participants experienced
dehydration symptoms (thirst, dizziness), and 22.2% broke
their fast for safety reasons, there were no hospitalizations.
None of the patients required additional desmopressin
dose adjustments. Most patients (66.7%) maintained twicedaily desmopressin dosing (Sahur and Iftar). Anterior
pituitary deficiencies were present in 70.3% of the cohort.
Conclusion:Despite being classified as very high risk, many AVP-D
patients safely complete Ramadan fasting without severe
adverse events. However, the high rate of dehydration
symptoms and the significant gap in pre-Ramadan
counseling (44.2% un-counseled) highlight the need for
structured clinical reviews 4–6 weeks prior to Ramadan to
optimize hydration and dosing
- Full text:2026080413465293242EP_A111.pdf
