Optimizing Kidney Disease Management during Ramadan: Evidence-Based Risk Stratification and Tailored Strategies

Fasting during Ramadan poses distinct challenges for individuals with kidney disease, requiring a careful balance between spiritual commitments and health maintenance. This article combines insights from recent research and guidelines to offer a thorough framework for risk assessment. Patients are classified into low, moderate, and high-risk categories based on individual, environmental, and health-related factors. Management approaches are organized into four main areas: spiritual support, non-drug interventions, medication adjustments, and modifications to kidney replacement therapy (KRT). Evidence indicates that stable chronic kidney disease (CKD) patients, especially those in stages 1-3, and kidney transplant recipients with stable graft function can fast safely with careful supervision. Conversely, patients with advanced CKD, those on dialysis, and individuals with significant additional health issues are advised against fasting due to possible complications. Essential recommendations include optimizing hydration, customizing medication plans, conducting regular monitoring, and making dietary adjustments. By merging medical knowledge with cultural awareness, healthcare providers can facilitate safe fasting and enhance health outcomes during Ramadan.