Fastng ramadan & kidney disease may 2017b

1. Prof Nagy Sayed-Ahmed
Mansoura University

2. ُ‫م‬ُ‫ك‬ْ‫ي‬َ‫ل‬َ‫ع‬ َ‫ب‬ِ‫ت‬ُ‫ك‬ ‫وا‬ُ‫ن‬َ‫م‬َ‫آ‬ َ‫ين‬ِ‫ذ‬َّ‫ال‬ ‫َا‬‫ه‬ُّ‫ي‬َ‫أ‬ ‫َا‬‫ي‬َّ‫ال‬ ‫ى‬َ‫ل‬َ‫ع‬ َ‫ب‬ِ‫ت‬ُ‫ك‬ ‫َا‬‫م‬َ‫ك‬ ُ‫َام‬‫ي‬ِ‫الص‬َ‫ين‬ِ‫ذ‬
َ‫ون‬ُ‫ق‬َّ‫ت‬َ‫ت‬ ْ‫م‬ُ‫ك‬َّ‫ل‬َ‫ع‬َ‫ل‬ ْ‫م‬ُ‫ك‬ِ‫ل‬ْ‫ب‬َ‫ق‬ ْ‫ن‬ِ‫م‬(183)
‫ي‬ِ‫َر‬‫م‬ ْ‫م‬ُ‫ك‬ْ‫ن‬ِ‫م‬ َ‫ان‬َ‫ك‬ ْ‫َن‬‫م‬َ‫ف‬ ٍ‫ت‬‫َا‬‫د‬‫و‬ُ‫د‬ْ‫َع‬‫م‬ ‫ا‬ً‫م‬‫ا‬َّ‫ي‬َ‫أ‬َّ‫د‬ِ‫ع‬َ‫ف‬ ٍ‫ر‬َ‫ف‬ َ‫س‬ ‫ى‬َ‫ل‬َ‫ع‬ ْ‫و‬َ‫أ‬ ‫ا‬ً‫ض‬ْ‫ن‬ِ‫م‬ ٌ‫ة‬
ِ‫ف‬ ُ‫ه‬َ‫ن‬‫و‬ُ‫يق‬ِ‫ط‬ُ‫ي‬ َ‫ين‬ِ‫ذ‬َّ‫ال‬ ‫ى‬َ‫ل‬َ‫َع‬‫و‬ َ‫ر‬َ‫خ‬
ُ
‫أ‬ ٍ‫م‬‫ا‬َّ‫ي‬َ‫أ‬َ‫م‬َ‫ف‬ ٍ‫ين‬ِ‫ك‬ ْ‫س‬ِ‫م‬ ُ‫ام‬َ‫ع‬َ‫ط‬ ٌ‫َة‬‫ي‬ْ‫د‬ْ‫ن‬
ُ‫ص‬َ‫ت‬ ْ‫ن‬َ‫َأ‬‫و‬ ُ‫ه‬َ‫ل‬ ٌ‫ر‬ْ‫ي‬َ‫خ‬ َ‫و‬ُ‫ه‬َ‫ف‬ ‫ا‬ً‫ر‬ْ‫ي‬َ‫خ‬ َ‫ع‬َّ‫و‬َ‫ط‬َ‫ت‬ْ‫م‬ُ‫ت‬ْ‫ن‬ُ‫ك‬ ْ‫ن‬ِ‫إ‬ ْ‫م‬ُ‫ك‬َ‫ل‬ ٌ‫ر‬ْ‫ي‬َ‫خ‬ ‫وا‬ُ‫م‬‫و‬َ‫ون‬ُ‫م‬َ‫ل‬ْ‫ع‬َ‫ت‬
(184)
َ‫آ‬ْ‫ر‬ُ‫ق‬ْ‫ال‬ ِ‫ه‬‫ي‬ِ‫ف‬ َ‫ل‬ِ‫ز‬ْ‫ن‬
ُ
‫أ‬ ‫ي‬ِ‫ذ‬َّ‫ال‬ َ‫ان‬َ‫ض‬َ‫م‬َ‫ر‬ ُ‫ر‬ْ‫ه‬ َ‫ش‬ٍ‫ت‬‫َا‬‫ن‬ِ‫َي‬‫ب‬َ‫و‬ ِ‫اس‬َّ‫ن‬‫ل‬ِ‫ل‬ ‫ى‬ً‫د‬ُ‫ه‬ ُ‫ن‬َ‫ن‬ِ‫م‬
‫ا‬ ُ‫م‬ُ‫ك‬ْ‫ن‬ِ‫م‬ َ‫د‬ِ‫ه‬ َ‫ش‬ ْ‫َن‬‫م‬َ‫ف‬ ِ‫ن‬‫ا‬َ‫ق‬ْ‫ر‬ُ‫ف‬ْ‫َال‬‫و‬ ‫َى‬‫د‬ُ‫ه‬ْ‫ال‬ْ‫َن‬‫م‬َ‫و‬ ُ‫ه‬ْ‫م‬ُ‫ص‬َ‫ي‬ْ‫ل‬َ‫ف‬ َ‫ر‬ْ‫ه‬ َّ‫لش‬َ‫ان‬َ‫ك‬
َّ‫ي‬َ‫أ‬ ْ‫ن‬ِ‫م‬ ٌ‫ة‬َّ‫د‬ِ‫ع‬َ‫ف‬ ٍ‫ر‬َ‫ف‬ َ‫س‬ ‫ى‬َ‫ل‬َ‫ع‬ ْ‫و‬َ‫أ‬ ‫ا‬ً‫ض‬‫ي‬ِ‫َر‬‫م‬ُ‫م‬ُ‫ك‬ِ‫ب‬ ُ َّ‫اَّلل‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬ َ‫ر‬َ‫خ‬
ُ
‫أ‬ ٍ‫م‬‫ا‬َ‫ر‬ ْ‫س‬ُ‫ي‬ْ‫ال‬
ْ‫ال‬ ‫وا‬ُ‫ل‬ِ‫م‬ْ‫ك‬ُ‫ت‬ِ‫ل‬َ‫و‬ َ‫ر‬ ْ‫س‬ُ‫ع‬ْ‫ال‬ ُ‫م‬ُ‫ك‬ِ‫ب‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬ َ‫ََل‬‫و‬َ‫ع‬ َ َّ‫اَّلل‬ ‫وا‬ُ‫ر‬ِ‫ب‬َ‫ك‬ُ‫ت‬ِ‫ل‬َ‫و‬ َ‫ة‬َّ‫د‬ِ‫ع‬‫َا‬‫م‬ ‫ى‬َ‫ل‬
َ‫ون‬ُ‫ر‬ُ‫ك‬ ْ‫ش‬َ‫ت‬ ْ‫م‬ُ‫ك‬َّ‫ل‬َ‫ع‬َ‫َل‬‫و‬ ْ‫م‬ُ‫َاك‬‫د‬َ‫ه‬(185)

3. • A fast does not chemically begin until the
carbohydrate stores in the body begin to be
used as an energy source
• The fast will continue as long as fat and
carbohydrate stores are used for energy, as
opposed to protein stores
• Once protein stores begin to be depleted for
energy (resulting in loss of muscle mass) a
person is technically starving

4.  Fasting is an integral part of many of the
major religions including Islam, Judaism and
Christianity
 Many are dubious as to whether the
physiological effects are beneficial

5. Fasting Ramadan is unique
metabolic model
Ramadan fasting is not a prolonged or continuous fasting, but consists of alternate
fasting and feasting periods (i.e.: intermittent feeding).

6. Ramadan fasting in
numbers
Ramadan duration is variable, since the Islamic calendar is a lunar one and
therefore the Islamic year contains 354 .
For this reason, the Ramadan month occurs 11 days earlier every year, and
may fall in any period of the year, making a full circle in a span of 33 years.
Therefore, mean fasting duration is usually 12-14 h, but depending on the
place and the year it can last also up to 18 h or even 22 h, in the extreme
latitudes.
First day of fasting on May 27 or 28

7. http://www.ansaralsonna.com/web/play-5359.html

8. ‫داود‬ ‫أبو‬ ‫رواه‬(2318)‫ف‬ ٍ‫اس‬َّ‫ب‬َ‫ع‬ ِ‫ن‬ْ‫ب‬‫ا‬ ْ‫ن‬َ‫ع‬‫ي‬
‫تعالى‬ ‫قوله‬:
(ِ‫ط‬ُ‫ي‬ َ‫ين‬ِ‫ذ‬َّ‫ال‬ ‫ى‬َ‫ل‬َ‫ع‬َ‫و‬ُ‫ه‬َ‫ن‬‫و‬ُ‫يق‬
ِ‫ك‬ ْ‫س‬ِ‫م‬ ُ‫ام‬َ‫ع‬َ‫ط‬ ٌ‫ة‬َ‫ي‬ْ‫د‬ِ‫ف‬ٍ‫ين‬)
َ‫ل‬‫ا‬َ‫ق‬:ْ‫ال‬ ِ‫خ‬ْ‫ي‬ َّ‫لش‬ِ‫ل‬ ً‫ة‬َ‫ص‬ْ‫خ‬ُ‫ر‬ ْ‫ت‬َ‫ن‬‫ا‬َ‫ك‬ِ‫ة‬َ‫أ‬ْ‫ر‬َ‫م‬ْ‫ال‬َ‫و‬ ِ‫ر‬‫ي‬ِ‫ب‬َ‫ك‬
ِ‫الص‬ ِ‫ن‬‫ا‬َ‫ق‬‫ي‬ِ‫ط‬ُ‫ي‬ ‫ا‬َ‫م‬ُ‫ه‬َ‫و‬ ِ‫ة‬َ‫ر‬‫ي‬ِ‫ب‬َ‫ك‬ْ‫ال‬ُ‫ي‬َ‫و‬ ‫ا‬َ‫ر‬ِ‫ط‬ْ‫ف‬ُ‫ي‬ ْ‫ن‬َ‫أ‬ َ‫م‬‫ا‬َ‫ي‬‫ا‬َ‫م‬ِ‫ع‬ْ‫ط‬
‫ا‬ً‫ن‬‫ي‬ِ‫ك‬ ْ‫س‬ِ‫م‬ ٍ‫م‬ْ‫و‬َ‫ي‬ ِ‫ل‬ُ‫ك‬ َ‫ان‬َ‫ك‬َ‫م‬.
‫النووي‬ ‫قال‬:‫حسن‬ ‫إسناده‬.

9. ْ‫َه‬‫ي‬َ‫و‬ ْ‫م‬ُ‫ك‬َ‫ل‬ َ‫ن‬ِ‫ي‬َ‫ب‬ُ‫ي‬ِ‫ل‬ ُ َّ‫اَّلل‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬ْ‫ن‬ِ‫م‬ َ‫ين‬ِ‫ذ‬َّ‫ال‬ َ‫َن‬‫ن‬ ُ‫س‬ ْ‫م‬ُ‫َك‬‫ي‬ِ‫د‬ْ‫م‬ُ‫ك‬ِ‫ل‬ْ‫ب‬َ‫ق‬
ِ‫ك‬َ‫ح‬ ٌ‫م‬‫ي‬ِ‫ل‬َ‫ع‬ ُ َّ‫َاَّلل‬‫و‬ ْ‫م‬ُ‫ك‬ْ‫ي‬َ‫ل‬َ‫ع‬ َ‫وب‬ُ‫ت‬َ‫ي‬َ‫و‬ٌ‫م‬‫ي‬(26)ْ‫ن‬َ‫أ‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬ ُ َّ‫َاَّلل‬‫و‬
َ‫ي‬ َ‫ين‬ِ‫ذ‬َّ‫ال‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬َ‫و‬ ْ‫م‬ُ‫ك‬ْ‫ي‬َ‫ل‬َ‫ع‬ َ‫وب‬ُ‫ت‬َ‫ي‬َ‫ت‬ ْ‫ن‬َ‫أ‬ ِ‫ت‬‫َا‬‫و‬َ‫ه‬ َّ‫الش‬ َ‫ون‬ُ‫ع‬ِ‫ب‬َّ‫ت‬‫وا‬ُ‫يل‬ِ‫م‬
‫ا‬ً‫م‬‫ي‬ِ‫ظ‬َ‫ع‬ ً‫ًل‬ْ‫ي‬َ‫م‬(27)َ‫ف‬ِ‫ف‬َ‫خ‬ُ‫ي‬ ْ‫ن‬َ‫أ‬ ُ َّ‫اَّلل‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬َ‫ق‬ِ‫ل‬ُ‫َخ‬‫و‬ ْ‫م‬ُ‫ك‬ْ‫ن‬َ‫ع‬
‫ا‬ً‫ف‬‫ي‬ِ‫ع‬َ‫ض‬ ُ‫ان‬ َ‫س‬ْ‫ن‬ِ ْ‫اْل‬(28)‫و‬ُ‫ن‬َ‫م‬َ‫آ‬ َ‫ين‬ِ‫ذ‬َّ‫ال‬ ‫َا‬‫ه‬ُّ‫ي‬َ‫أ‬ ‫َا‬‫ي‬‫وا‬ُ‫ل‬ُ‫ك‬ْ‫أ‬َ‫ت‬ َ‫َل‬ ‫ا‬
َّ‫َل‬ِ‫إ‬ ِ‫ل‬ِ‫ط‬‫ا‬َ‫ب‬ْ‫ال‬ِ‫ب‬ ْ‫م‬ُ‫َك‬‫ن‬ْ‫ي‬َ‫ب‬ ْ‫م‬ُ‫ك‬َ‫َال‬‫و‬ْ‫م‬َ‫أ‬َ‫ت‬ ْ‫ن‬َ‫ع‬ ً‫ة‬َ‫ر‬‫َا‬‫ج‬ِ‫ت‬ َ‫ون‬ُ‫ك‬َ‫ت‬ ْ‫ن‬َ‫أ‬ٍ‫اض‬َ‫ر‬
ْ‫م‬ُ‫ك‬ْ‫ن‬ِ‫م‬ْ‫م‬ُ‫ك‬ َ‫س‬ُ‫ف‬ْ‫ن‬َ‫أ‬ ‫وا‬ُ‫ل‬ُ‫ت‬ْ‫ق‬َ‫ت‬ َ‫َل‬َ‫و‬َ‫ر‬ ْ‫م‬ُ‫ك‬ِ‫ب‬ َ‫ان‬َ‫ك‬ َ َّ‫اَّلل‬ َّ‫ن‬ِ‫إ‬‫ا‬ً‫م‬‫ي‬ِ‫ح‬
(29)ْ‫ل‬ُ‫َظ‬‫و‬ ‫ا‬ً‫ن‬‫َا‬‫و‬ْ‫د‬ُ‫ع‬ َ‫ك‬ِ‫ل‬َ‫ذ‬ ْ‫ل‬َ‫ع‬ْ‫َف‬‫ي‬ ْ‫َن‬‫م‬َ‫و‬ِ‫ه‬‫ي‬ِ‫ل‬ْ‫ص‬ُ‫ن‬ َ‫ف‬ْ‫و‬ َ‫س‬َ‫ف‬ ‫ا‬ً‫م‬‫ا‬ً‫ر‬‫ا‬َ‫ن‬
‫ا‬ً‫ر‬‫ي‬ِ‫س‬َ‫ي‬ ِ َّ‫اَّلل‬ ‫ى‬َ‫ل‬َ‫ع‬ َ‫ك‬ِ‫ل‬َ‫ذ‬ َ‫ان‬َ‫َك‬‫و‬(30)َ‫ك‬ ‫وا‬ُ‫ب‬ِ‫ن‬َ‫ت‬ْ‫ج‬َ‫ت‬ ْ‫ن‬ِ‫إ‬‫َا‬‫م‬ َ‫ر‬ِ‫ئ‬‫ا‬َ‫ب‬
ِ‫ي‬ َ‫س‬ ْ‫م‬ُ‫ك‬ْ‫ن‬َ‫ع‬ ْ‫ر‬ِ‫ف‬َ‫ك‬ُ‫ن‬ ُ‫ه‬ْ‫ن‬َ‫ع‬ َ‫ن‬ْ‫و‬َ‫ه‬ْ‫ن‬ُ‫ت‬ُ‫م‬ ْ‫م‬ُ‫ك‬ْ‫ل‬ِ‫خ‬ْ‫د‬ُ‫ن‬َ‫و‬ ْ‫م‬ُ‫ك‬ِ‫ت‬‫ا‬َ‫ئ‬ً‫ًل‬َ‫خ‬ْ‫د‬
‫ا‬ً‫م‬‫ي‬ِ‫ر‬َ‫ك‬(31)

10. (َ َّ‫اَّلل‬ َّ‫ن‬ِ‫إ‬ ْ‫م‬ُ‫ك‬ َ‫س‬ُ‫ف‬ْ‫ن‬َ‫أ‬ ‫وا‬ُ‫ل‬ُ‫ت‬ْ‫ق‬َ‫ت‬ َ‫َل‬َ‫و‬‫ا‬ً‫م‬‫ي‬ِ‫ح‬َ‫ر‬ ْ‫م‬ُ‫ك‬ِ‫ب‬ َ‫ان‬َ‫ك‬(29)
ً‫م‬ْ‫ل‬ُ‫ظ‬َ‫و‬ ‫ا‬ً‫ن‬‫ا‬َ‫و‬ْ‫د‬ُ‫ع‬ َ‫ك‬ِ‫ل‬َ‫ذ‬ ْ‫ل‬َ‫ع‬ْ‫ف‬َ‫ي‬ ْ‫ن‬َ‫م‬َ‫و‬َ‫ن‬ ِ‫ه‬‫ي‬ِ‫ل‬ْ‫ص‬ُ‫ن‬ َ‫ف‬ْ‫و‬ َ‫س‬َ‫ف‬ ‫ا‬‫ا‬ً‫ر‬‫ا‬
‫ا‬ً‫ر‬‫ي‬ِ‫س‬َ‫ي‬ ِ َّ‫اَّلل‬ ‫ى‬َ‫ل‬َ‫ع‬ َ‫ك‬ِ‫ل‬َ‫ذ‬ َ‫ان‬َ‫ك‬َ‫و‬(30))
‫الجوزي‬ ‫بن‬ ‫قال‬‫هللا‬ ‫رحمه‬
‫أقوال‬ ‫خمسة‬ ‫فيه‬ ‫تعالى‬ ‫قوله‬:
‫أحدها‬........... :
..........
‫والثالث‬:‫المعنى‬ ‫أن‬:‫أنفسكم‬ ‫تكلفوا‬ ‫َل‬ً‫عمال‬
‫فرضا‬ ‫كان‬ ‫ن‬ِ‫وإ‬ ‫قتلها‬ ‫إلى‬ ‫أدى‬ ‫ما‬‫رب‬

11. ‫في‬ ‫العاص‬ ‫بن‬ ‫عمرو‬ ‫تأولها‬ ‫هذا‬ ‫وعلى‬
‫صلى‬ ‫حيث‬ ‫السالسل‬ ‫ذات‬ ‫غزاة‬
‫ف‬ ، ‫باردة‬ ‫ليلة‬ ‫في‬ ً‫نبا‬ُ‫ج‬ ‫بأصحابه‬‫ذكر‬ ‫لما‬
‫للنبي‬ ‫ذلك‬-‫وسل‬ ‫عليه‬ ‫هللا‬ ‫صلى‬‫م‬-
‫له‬ ‫قال‬:‫وأ‬ ‫بأصحابك‬ ‫صليت‬ ‫عمرو‬ ‫يا‬‫نت‬
‫يا‬ ‫فقال‬ ‫جنب؟‬‫ني‬ِ‫إ‬ ‫هللا‬ ‫رسول‬
ِ‫إ‬ ‫وأشفقت‬ ‫باردة‬ ‫ليلة‬ ‫في‬ ُ‫احتلمت‬‫ن‬
‫قوله‬ ‫فذكرت‬ ، ‫ك‬ِ‫ل‬‫أه‬ ‫أن‬ ‫اغتسلت‬
‫تعالى‬:"‫أنفسكم‬ ‫تقتلوا‬ ‫وَل‬"‫فض‬‫حك‬
‫هللا‬ ‫رسول‬-‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬

12. ‫التهلكة‬:‫المعاناة‬ ‫و‬ ‫العذاب‬ ‫و‬ ، ‫الهالك‬ ‫أي‬
‫األليمة‬ ‫و‬ ‫الشديدة‬..‫جميع‬ ‫من‬ ‫فينبغي‬
‫الهالك‬ ‫و‬ ‫التهلكة‬ ‫عن‬ ‫إرادتهم‬ ‫إبعاد‬ ‫المسلمين‬.
‫تعالى‬ ‫قال‬
ِ َّ‫اَّلل‬ ِ‫يل‬ِ‫ب‬ َ‫س‬ ‫ي‬ِ‫ف‬ ‫وا‬ُ‫ق‬ِ‫ف‬ْ‫ن‬َ‫أ‬َ‫و‬ُ‫ق‬ْ‫ل‬ُ‫ت‬ َ‫َل‬َ‫و‬‫وا‬
ُ‫ل‬ْ‫ه‬َّ‫الت‬ ‫ى‬َ‫ل‬ِ‫إ‬ ْ‫م‬ُ‫يك‬ِ‫د‬ْ‫ي‬َ‫أ‬ِ‫ب‬َّ‫ن‬ِ‫إ‬ ‫وا‬ُ‫ن‬ِ‫س‬ْ‫ح‬َ‫أ‬َ‫و‬ ِ‫ة‬َ‫ك‬
‫ي‬ِ‫ن‬ِ‫س‬ْ‫ح‬ُ‫م‬ْ‫ال‬ ُّ‫ب‬ِ‫ح‬ُ‫ي‬ َ َّ‫اَّلل‬َ‫ن‬
(‫اآلية‬ ‫البقرة‬195)

13. ‫النبي‬ ‫عن‬ ‫عنه‬ ‫هللا‬ ‫رضي‬ ‫هريرة‬ ‫أبي‬ ‫عن‬
‫قال‬ ‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬:
«‫الدي‬ ‫يشاد‬ ‫ولن‬ ‫يسر‬ ‫الدين‬ ‫إن‬‫ن‬
،‫وقاربوا‬ ‫فسددوا‬ ،‫غلبه‬ ‫إَل‬ ‫أحد‬
‫بالغدوة‬ ‫واستعينوا‬ ،‫وأبشروا‬
‫الدلجة‬ ‫من‬ ‫وشيء‬ ‫والروحة‬».
[‫البخاري‬ ‫رواه‬39[

14. ‫مع‬ ‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬ ‫النبي‬ ‫بعث‬ ‫لما‬‫بن‬ ‫اذ‬
‫عنهما‬ ‫هللا‬ ‫رضي‬ ‫األشعري‬ ‫موسى‬ ‫وأبا‬ ‫جبل‬
‫لهما‬ ‫قال‬:
«،‫تعسرا‬ ‫وَل‬ ‫را‬‫يس‬
‫تنفرا‬ ‫وَل‬ ‫وبشرا‬».
[‫البخاري‬ ‫رواه‬3038.]

15. ‫صلى‬ ‫النبي‬ ‫أن‬ ‫عنها‬ ‫هللا‬ ‫رضي‬ ‫عائشة‬ ‫عن‬
‫قال‬ ‫وسلم‬ ‫عليه‬ ‫هللا‬:
«‫يبعثني‬ ‫لم‬ ‫هللا‬ ‫إن‬
‫ول‬ ‫ا‬ً‫ت‬‫متعن‬ ‫وَل‬ ‫ا‬ً‫ت‬‫معن‬‫كن‬
ً‫ر‬‫ميس‬ ‫ا‬ً‫م‬‫معل‬ ‫بعثني‬‫ا‬».
[‫مسلم‬ ‫رواه‬1478.]

16. ‫اإلجماع‬
‫التكليف‬ ‫أن‬ ‫على‬ ‫األمة‬ ‫أجمعت‬
،‫التشريع‬ ‫في‬ ‫يقع‬ ‫لم‬ ‫الشاق‬
‫الشارع‬ ‫قصد‬ ‫عدم‬ ‫على‬ ‫يدل‬ ‫وهو‬
‫ا‬ً‫د‬‫قاص‬ ‫الشارع‬ ‫كان‬ ‫ولو‬ ،‫إليه‬
‫كا‬ ‫لما‬ ‫التكليف‬ ‫في‬ ‫للمشقة‬‫ن‬
ٌ‫تخفيف‬ ‫وَل‬ ٌ‫ترخيص‬ ‫هناك‬.

17. ‫تعريفه‬:‫والنظائر‬ ‫األشباه‬ ‫في‬ ‫السيوطي‬ ‫عرفه‬‫بأنه‬
«‫حد‬ ‫إلى‬ ‫اَلعتدال‬ ‫حد‬ ‫عن‬ ‫المكلف‬ ‫العبد‬ ‫بدن‬ ‫خروج‬
‫بال‬ ‫عليه‬ ‫فيؤثر‬ ‫الجسم‬ ‫على‬ ‫يطرأ‬ ‫الذي‬ ‫الضعف‬‫عجز‬
‫عزيمة‬ ‫طلب‬ ‫كما‬ ‫الشرعي‬ ‫الواجب‬ ‫بأداء‬ ‫القيام‬ ‫عن‬».
‫دليله‬:‫تعالى‬ ‫قوله‬:
«َ‫ل‬َ‫ع‬ ْ‫و‬َ‫أ‬ ‫ا‬ً‫ض‬‫ي‬ِ‫ر‬َ‫م‬ َ‫ان‬َ‫ك‬ ْ‫ن‬َ‫م‬َ‫و‬َّ‫د‬ِ‫ع‬َ‫ف‬ ٍ‫ر‬َ‫ف‬ َ‫س‬ ‫ى‬ٌ‫ة‬
ُ َّ‫اَّلل‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬ َ‫ر‬َ‫خ‬
ُ
‫أ‬ ٍ‫م‬‫ا‬َّ‫ي‬َ‫أ‬ ْ‫ن‬ِ‫م‬َ‫ر‬ ْ‫س‬ُ‫ي‬ْ‫ال‬ ُ‫م‬ُ‫ك‬ِ‫ب‬َ‫َل‬َ‫و‬
َ َ‫ر‬ ْ‫س‬ُ‫ع‬ْ‫ال‬ ُ‫م‬ُ‫ك‬ِ‫ب‬ ُ‫يد‬ِ‫ر‬ُ‫ي‬»
[‫البقرة‬:185.]

18. ‫أقسام‬ ‫ثالثة‬ ‫والمرض‬:
‫األول‬ ‫القسم‬:
‫المريض‬‫برؤه‬ ‫يرجى‬ ‫َل‬ ‫ا‬ً‫ض‬‫مر‬‫هو‬ ‫بل‬ ،
،‫مستمر‬‫عليه‬ ‫صيام‬ ‫َل‬ ‫فهذا‬‫ولكن‬ ،‫عليه‬
‫جنس‬ ‫من‬ ‫ألنه‬ ‫ا؛‬ً‫ن‬‫مسكي‬ ‫يوم‬ ‫كل‬ ‫عن‬ ‫يطعم‬ ‫أن‬
‫زوا‬ ‫رجى‬ُ‫ي‬ ‫َل‬ ‫الذي‬ ‫الصوم‬ ‫عن‬ ‫العاجز‬ ‫الكبير‬‫ل‬
‫عجزه‬.

19. ‫الثاني‬ ‫القسم‬:
‫المريض‬‫الصوم‬ ‫يضره‬ ‫ا‬ً‫ض‬‫مر‬:‫ويخشى‬‫عليه‬
‫ع‬ ‫اَلستغناء‬ ‫يستطيع‬ ‫َل‬ ‫كمريض‬ ،‫به‬ ‫يهلك‬ ‫أن‬‫ن‬
‫ذلك‬ ‫وغير‬ ‫السكري‬ ‫المرض‬ ‫أنواع‬ ‫بعض‬ ‫مثل‬ ‫الماء‬،
‫فهذا‬‫الصوم‬ ‫عليه‬ ‫يحرم‬‫؛‬
‫تعالى‬ ‫لقوله‬:
«َ‫س‬ُ‫ف‬ْ‫ن‬َ‫أ‬ ‫وا‬ُ‫ل‬ُ‫ت‬ْ‫ق‬َ‫ت‬ َ‫َل‬َ‫و‬َ َّ‫اَّلل‬ َّ‫ن‬ِ‫إ‬ ْ‫م‬ُ‫ك‬َ‫ان‬َ‫ك‬
‫ا‬ً‫م‬‫ي‬ِ‫ح‬َ‫ر‬ ْ‫م‬ُ‫ك‬ِ‫ب‬»
[‫النساء‬:29.]

20. ‫الثالث‬ ‫القسم‬:
‫فيه‬ ‫ضرر‬ ‫َل‬ ‫لكن‬ ‫الصوم‬ ‫معه‬ ‫يشق‬ ‫مرض‬:
‫بع‬ ‫ويقضي‬ ،‫يصوم‬ ‫وَل‬ ‫يفطر‬ ‫أن‬ ‫واألفضل‬‫د‬
،‫ذلك‬
‫كمرض‬ ،‫الصيام‬ ‫به‬ ‫يتأثر‬ ‫َل‬ ‫الذي‬ ‫المرض‬ ‫وأما‬
‫ذلك‬ ‫أشبه‬ ‫وما‬ ،‫السن‬ ‫ومرض‬ ‫اليسير‬ ‫العين‬،
‫من‬ ‫الحكمة‬ ‫ألن‬ ‫الفطر؛‬ ‫فيه‬ ‫يجوز‬ ‫َل‬ ‫فإنه‬
‫مشقة‬ ‫َل‬ ‫وهذا‬ ،‫المشقة‬ ‫إزالة‬ ‫هي‬ ‫الرخصة‬
‫و‬ ‫واألصل‬ ،‫الفطر‬ ‫له‬ ‫يحل‬ ‫فال‬ ،‫ا‬ً‫إطالق‬ ‫عليه‬‫جوب‬
‫ي‬ ‫واضح‬ ‫ن‬‫بي‬ ‫بدليل‬ ‫إَل‬ ‫وقته‬ ‫في‬ ‫الصوم‬‫بيح‬
‫ذلك‬ ‫بعد‬ ‫يقضي‬ ‫ثم‬ ‫يفطر‬ ‫أن‬ ‫لإلنسان‬.

21. ‫زواله‬ ‫يرجى‬ ‫َل‬ ‫أي‬ ‫برؤه‬ ‫يرجى‬ ‫َل‬ ‫ا‬ً‫ض‬‫مر‬ ‫ا‬ً‫ض‬‫مري‬ ‫كان‬ ‫إن‬
‫مريض‬ ‫مثل‬‫الكلوي‬ ‫الفشل‬‫ف‬ُ‫ي‬ ‫فهذا‬ ،‫سي‬ ‫فيرس‬ ‫أو‬‫طر‬
‫م‬ ‫ا‬ًّ‫مد‬ ‫يوم‬ ‫كل‬ ‫عن‬ ‫مسكين‬ ‫إطعام‬ ‫وهي‬ ،‫الفدية‬ ‫وعليه‬‫ن‬
‫ونحوهما‬ ‫أرز‬ ‫أو‬ ‫قمح‬ ‫من‬ ‫صاع‬ ‫ربع‬ ‫أي‬ ،‫طعام‬(‫حوالي‬
‫الو‬ ‫يطعم‬ ‫أن‬ ‫واألفضل‬ ،ً‫قليال‬ ‫يزيد‬ ‫أو‬ ‫كيلو‬ ‫نصف‬‫اجد‬
‫كفا‬ ‫على‬ ‫ا‬ ً‫قياس‬ ‫أهله؛‬ ‫يطعم‬ ‫ما‬ ‫أوسط‬ ‫من‬ ‫ا‬ً‫ن‬‫مسكي‬‫رة‬
‫ا‬ ‫للفقير‬ ‫األنفع‬ ‫وهذا‬ ،‫القرآن‬ ‫في‬ ‫المذكورة‬ ‫اليمين‬،‫آلن‬
‫لم‬ ‫إذا‬ ‫الكبير‬ ‫الشيخ‬ ‫وأما‬ ،‫صحيحه‬ ‫في‬ ‫البخاري‬ ‫قال‬
‫عامي‬ ‫أو‬ ‫ا‬ً‫م‬‫عا‬ ‫كبر‬ ‫بعدما‬ ‫أنس‬ ‫أطعم‬ ‫فقد‬ ‫الصيام‬ ‫يطق‬‫ن‬
‫وأفطر‬ ،‫ا‬ً‫م‬‫ولح‬ ‫ا‬ً‫ز‬‫خب‬ ‫ا‬ً‫ن‬‫مسكي‬ ‫يوم‬ ‫كل‬.
‫مع‬ ‫يشق‬ ‫ولكن‬ ،‫برؤه‬ ‫يرجى‬ ‫ا‬ً‫ض‬‫مر‬ ‫ا‬ً‫ض‬‫مري‬ ‫كان‬ ‫إن‬ ‫أما‬‫ه‬
‫ذلك‬ ‫بعد‬ ‫القضاء‬ ‫وعليه‬ ‫الفطر‬ ‫فله‬ ‫الصوم‬

23. ‫َلنخفاض‬ ‫الشتاء‬ ‫فترة‬ ‫في‬ ‫تصوم‬ ‫الحيوانات‬ ‫بعض‬
،‫الغذاء‬ ‫وقلة‬ ‫الحرارة‬
)ْ‫ب‬ِ‫ع‬َ‫ل‬ ِ‫م‬‫ا‬َ‫ع‬ْ‫ن‬َ ْ‫األ‬ ‫ي‬ِ‫ف‬ ْ‫م‬ُ‫ك‬َ‫ل‬ َّ‫ن‬ِ‫إ‬َ‫و‬ً‫ة‬َ‫ر‬(
‫الحيوانات‬ ‫بعض‬‫بل‬ ‫أياما‬ ‫جحورها‬ ‫في‬ ‫تسكن‬
‫والطعام‬ ‫الحركة‬ ‫عن‬ ‫فيها‬ ‫تمتنع‬ ‫متوالية‬ ‫شهورا‬
‫الطيور‬ ‫من‬‫عن‬ ‫ويمتنع‬ ‫عشه‬ ‫في‬ ‫يكمن‬ ‫ما‬
‫عام‬ ‫كل‬ ‫معينة‬ ‫مواسم‬ ‫في‬ ‫الطعام‬
‫األسماك‬ ‫بعض‬‫ا‬ ‫أو‬ ‫البحر‬ ‫قاع‬ ‫في‬ ‫نفسه‬ ‫يدفن‬‫لنهر‬
‫طعام‬ ‫بدون‬ ‫معينة‬ ‫لفترة‬
‫البرمائيات‬ ‫بعض‬‫ف‬ ‫الطين‬ ‫في‬ ‫نفسها‬ ‫تدفن‬‫فترة‬ ‫ي‬
‫الش‬ ‫البيات‬ ‫في‬ ‫الضفادع‬ ‫تفعل‬ ‫كما‬ ‫الشتاء‬

24. ‫لنفس‬ ‫يلتمس‬ ‫فإنه‬ ‫بالمرض‬ ‫يشعر‬ ‫عندما‬ ‫حيوان‬ ‫أي‬‫ه‬
‫أ‬ ،‫الطعام‬ ‫تناول‬ ‫عن‬ ‫يمتنع‬ ‫ثم‬ ‫فيه‬ ‫يرتاح‬ ‫هادئا‬ ‫مكانا‬‫ي‬
‫المرض‬ ‫فترة‬ ‫طوال‬ ‫طعام‬
‫لت‬ ‫أنها‬ ‫بل‬ ،‫مريضة‬ ‫تكون‬ ‫حينما‬ ‫الطعام‬ ‫تترك‬ ‫األبقار‬‫حكم‬
‫علي‬ ‫إجبارها‬ ‫وأطباؤها‬ ‫مربوها‬ ‫حاول‬ ‫إذا‬ ‫فكيها‬ ‫إغًلق‬
‫الطعام‬ ‫تناول‬
‫الم‬ ‫وقت‬ ‫الطعام‬ ‫عن‬ ‫تمتنع‬ ‫المنزلية‬ ‫والقطط‬ ‫الكًلب‬‫رض‬
‫إجب‬ ‫يحاولون‬ ‫عندما‬ ‫ألصحابها‬ ‫المضنية‬ ‫الجهود‬ ‫وتقاوم‬‫ارها‬
‫الطعام‬ ‫علي‬
‫ط‬ ‫بًل‬ ‫ساكنا‬ ‫ويظل‬ ً‫جانبا‬ ‫يأخذ‬ ‫المريض‬ ‫والدجاج‬ ‫البط‬‫عام‬
‫المرض‬ ‫فترة‬ ‫طوال‬ ‫شراب‬ ‫وَل‬

25. ‫الطعام‬ ‫ويرفض‬ ‫الشهية‬ ‫يفقد‬ ‫المريض‬ ‫اْلنسان‬
‫حوله‬ ‫من‬ ‫أن‬ ‫إَل‬ ‫عليها‬ ‫هللا‬ ‫فطره‬ ‫التي‬ ‫بغريزته‬
‫يحضونه‬‫ال‬ ‫على‬‫مري‬ ‫يكون‬ ‫حينما‬ ‫بالطعام‬ ‫تشبث‬‫ضا‬
‫للطعام‬ ‫شهية‬ ‫له‬ ‫تكن‬ ‫لم‬ ‫ولو‬ ‫حتى‬
‫ربه‬ ‫إن‬‫ف‬ ‫اب‬‫ر‬‫والش‬ ‫الطعام‬‫علي‬ ‫مرضاكم‬ ‫تكرهوا‬ ‫ال‬‫يطعمهم‬ ‫م‬
‫ويسقيهم‬

26. • The experiment was performed in the 1930s
by isolating one worm and putting it on a
cycle of fasting and feeding. The isolated
worm outlasted its relatives by 19
generations, while still maintaining its
youthful physiological traits. The worm was
able to survive on its own tissue for months.
Once the size of the worm began to
decrease, the scientists would resume
feeding it at which point it showed great
vigor and energy. "The life-span extension of
these worms was the equivalent of keeping a
man alive for 600 to 700 years."

27. Antiaging effects
Better attitude
Better resistance to
disease
Better sleep
Change of habits
Clearer planning
Clearer skin
Creativity
Diet changes
Drug detoxification
Improved senses
(vision, hearing, taste)
Inspiration
More clarity (mentally
and emotionally)
More energy
More relaxation
New ideas
Purification
Reduction of allergies
Rejuvenation
Rest for digestive organs
Revitalization
Right use of will
Spiritual awareness
Weight loss

28. • Emotionally, you will feel calmer, clearer
and happier.
• Fasters often report that depression lifts,
goals begin to feel more obtainable as
obstacles are put into proper focus.
• Doctors have reported patients
experiencing improved concentration,
less anxiety, sleeping better and waking
more refreshed.

29. • most medical experts agree that fasting is not a
healthy weight loss tool.
– quick fluid loss, not substantial weight loss
• Fasting slows your metabolic rate down so your diet
from before the fast is even more fattening after you
fast
• Fasting for weight loss carries other health risks as
well.
• More risky if you've got liver or kidney problems, any
kind of compromised immune system functioning, or
are on medication -- even Tylenol,"

30.  Pregnant women.
 People with wasting diseases or malnutrition.
 Those with a history of cardiac arrhythmias.
 People with hepatic or renal insufficiency.
Fuhrman, J., Sarter, B., Calabro, D.J., Alternative Therapies, 2001; 8(4):1-3.

31. • Food consumed during the pre-dawn and dusk
meals may lead to some unintended weight gain.
But if you approach the fast with discipline, it
can be an opportunity to lose weight and
become healthier
• Heartburn
• Poor control of diabetes
• Headache
• Dehydration
• Constipation
• Stress
• Weight control

32. Water
Salt
Nutritional Impact
Other Aspect of health
Progression of Renal
Disease

33. • The body continues to lose water and salts
through breathing, perspiring and urinating
• If you don’t drink sufficiently before a fast
your risk of dehydration is increased. This
risk is higher in older people and in those
taking tablets such as diuretics.
• If you are unable to stand up due to
dizziness, or you are disoriented, you should
urgently drink regular, moderate quantities
of water – ideally with sugar and salt

37. Water Mainly
 Hypertonicity
Water with salt
 Isotonic Dehadration
Salt only (after water compensation):
 Hypotonicity

44. Dependence of water clearance on daily solute excretion
at low urinary osmolalities.
Tomas Berl JASN 2008;19:1076-1078
©2008 by American Society of Nephrology

45. Effect of increasing solute excretion on urinary osmolality.
Tomas Berl JASN 2008;19:1076-1078
©2008 by American Society of Nephrology

46. Decreased time available for
eating
Decreased Gastric filling
Capacity
Nausea and Vomiting
Type of food in Ramadan:
 Hyperkalemia
 Hyperphosphatemia

47. Effect of Dehydration
Effect on Stone formation
Effect on renal nutrition
UTI
Effect on Immune System

53.  A small body mass loss is a frequent, but not
universal, outcome of Ramadan. During the daylight
hours of Ramadan fasting, practising Muslims are
undoubtedly dehydrating, but it is not clear whether
they are chronically hypohydrated during the month
ofRamadan. No detrimental effects on health have
as yet been directly attributed to negative water
balance at the levels that maybe produced during
Ramadan.

59. CKD Patients Who should not Fast:
 ?? GFR < 30
 ?? GFR < 15
CKD with other associated problems:
 Liver Disease
 Diabetes
 CVD
 Neurological Disease
What if the patient insisted to fast??