Optimizing Kidney Disease Management during Ramadan: Evidence-Based Risk Stratification and Tailored Strategies Authors Sourabh Sharma Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi; Manisha Sahay Department of Nephrology, Osmania Medical College, Hyderabad; Mastakim Ahmed Mazumder Guwahati Metro Hospital, Guwahati, Assam; Sanjay Kalra Department of Endocrinology, Bharti Hospital, Karnal, India; University Center for Research & Development, Chandigarh University, Mohali, India; DOI: https://doi.org/10.47391/JPMA.25-21 Abstract Fasting during Ramadan poses distinct challenges forindividuals with kidney disease, requiring a careful balancebetween spiritual commitments and health maintenance.This article combines insights from recent research andguidelines to offer a thorough framework for riskassessment. Patients are classified into low, moderate, andhigh-risk categories based on individual, environmental,and health-related factors. Management approaches areorganized into four main areas: spiritual support, non-druginterventions, medication adjustments, and modificationsto kidney replacement therapy (KRT). Evidence indicatesthat stable chronic kidney disease (CKD) patients, especiallythose in stages 1–3, and kidney transplant recipients withstable graft function can fast safely with carefulsupervision. Conversely, patients with advanced CKD, thoseon dialysis, and individuals with significant additionalhealth issues are advised against fasting due to possiblecomplications. Essential recommendations includeoptimizing hydration, customizing medication plans,conducting regular monitoring, and making dietaryadjustments. By merging medical knowledge with culturalawareness, healthcare providers can facilitate safe fastingand enhance health outcomes during Ramadan. Keywords: Ramadan, Chronic kidney disease, Religion,Fasting, Dialysis Downloads Full Text Article Published 2025-02-23 How to Cite Sourabh Sharma, Manisha Sahay, Mastakim Ahmed Mazumder, & Sanjay Kalra. (2025). Optimizing Kidney Disease Management during Ramadan: Evidence-Based Risk Stratification and Tailored Strategies. Journal of the Pakistan Medical Association, 75(03), 506–508. https://doi.org/10.47391/JPMA.25-21 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 75 No. 03 (2025): MARCH Section ADVANCES IN NEPHROLOGY License Copyright (c) 2025 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.