Regarding those who undergo dialysis, does the exit of blood during the session invalidate the ablution, and how does one fast and pray during kidney dialysis for the elderly?
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The questioner : Please issue a ruling, O honorable Shaykh, on one who undergoes dialysis. Does the exit of blood during the session invalidate the ablution? And how does one fast and pray during kidney dialysis for the elderly? The blood dialysis may coincide with the time of prayer. Please guide us in this matter.
The Shaykh : As for the invalidation of the ablution, it does not invalidate the ablution. This is because the stronger opinion among the scholars is that what exits the body does not invalidate the ablution except what exits from the two passages. What exits from the two passages invalidates the ablution, whether it is urine, feces, moisture, or wind. Everything that exits from the two passages invalidates the ablution. As for what exits from other than the two passages, such as a nosebleed exiting from the nose, or blood exiting from a wound, or the like, it does not invalidate the ablution, whether little or much. Accordingly, dialysis does not invalidate the ablution.
As for prayer, the afflicted man can combine the midday and afternoon prayers, and the sunset and night prayers. He should coordinate with the attending physician regarding the time so that the dialysis does not take up more than half the day, lest he miss the midday and afternoon prayers in their times. He can say to him, for example, "Delay the dialysis from the zenith by the amount of time I need to pray the midday and afternoon prayers," or "Advance it so that I can pray the midday and afternoon prayers before the time of the afternoon prayer ends." The important thing is that it is permissible for him to combine without delaying the prayer beyond its time. Accordingly, coordination with the attending physician is necessary.
As for fasting, I am hesitant about this. Sometimes I say that this is not like cupping, because in cupping, blood is extracted and does not return to the body, and this invalidates the fast as stated in the hadith. In dialysis, blood is extracted, cleaned, and returned to the body. However, I fear that there may be nourishing substances in this dialysis that suffice for food and drink. If that is the case, it breaks the fast. In that case, if a person is afflicted with this for a lifetime, he is one who is ill with an illness that is not expected to end, so he feeds one poor person for every day. As for if that is in one time and not another, he breaks his fast during the time of dialysis and makes it up afterwards. As for if this mixture that is mixed with the blood during dialysis does not nourish the body but only clarifies and purifies the blood, then it does not break the fast of the one fasting. In that case, he may use dialysis even while fasting. He should refer this matter to the doctors.
The questioner : May Allah reward you with good, Shaykh Muhammad.
The Shaykh : As for the invalidation of the ablution, it does not invalidate the ablution. This is because the stronger opinion among the scholars is that what exits the body does not invalidate the ablution except what exits from the two passages. What exits from the two passages invalidates the ablution, whether it is urine, feces, moisture, or wind. Everything that exits from the two passages invalidates the ablution. As for what exits from other than the two passages, such as a nosebleed exiting from the nose, or blood exiting from a wound, or the like, it does not invalidate the ablution, whether little or much. Accordingly, dialysis does not invalidate the ablution.
As for prayer, the afflicted man can combine the midday and afternoon prayers, and the sunset and night prayers. He should coordinate with the attending physician regarding the time so that the dialysis does not take up more than half the day, lest he miss the midday and afternoon prayers in their times. He can say to him, for example, "Delay the dialysis from the zenith by the amount of time I need to pray the midday and afternoon prayers," or "Advance it so that I can pray the midday and afternoon prayers before the time of the afternoon prayer ends." The important thing is that it is permissible for him to combine without delaying the prayer beyond its time. Accordingly, coordination with the attending physician is necessary.
As for fasting, I am hesitant about this. Sometimes I say that this is not like cupping, because in cupping, blood is extracted and does not return to the body, and this invalidates the fast as stated in the hadith. In dialysis, blood is extracted, cleaned, and returned to the body. However, I fear that there may be nourishing substances in this dialysis that suffice for food and drink. If that is the case, it breaks the fast. In that case, if a person is afflicted with this for a lifetime, he is one who is ill with an illness that is not expected to end, so he feeds one poor person for every day. As for if that is in one time and not another, he breaks his fast during the time of dialysis and makes it up afterwards. As for if this mixture that is mixed with the blood during dialysis does not nourish the body but only clarifies and purifies the blood, then it does not break the fast of the one fasting. In that case, he may use dialysis even while fasting. He should refer this matter to the doctors.
The questioner : May Allah reward you with good, Shaykh Muhammad.