Consensus recommendations on fasting during Ramadan for patients with kidney disease: review of available evidence and a call for action (RaK Initiative)

Abstract

Ramadan fasting (RF) involves abstaining from food and drink during daylight hours; it is obligatory for all healthy Muslims from the age of puberty. Although sick individuals are exempt from fasting, many will fast anyway. This article explores the impact of RF on individuals with kidney diseases through a comprehensive review of existing literature and consensus recommendations. This study was conducted by a multidisciplinary panel of experts.The recommendations aim to provide a structured approach to assess and manage fasting during Ramadan for patients with kidney diseases, empowering both healthcare providers and patients to make informed decisions while considering their unique circumstances.

Keywords: Chronic kidney disease; Dialysis; Ramadan fasting; Risk mitigation; Transplantation.

Fig. 1

RaK clinical assessment tool (3A’s: Assess, Advise & Assist): This figure delineates the RaK recommendations, organized into three steps. The initial step involves the pre-Ramadan assessment to classify the risk of fasting (risk classification), determining whether fasting is advised or not (second step). If a patient, identified with moderate or high risk, chooses to fast, the subsequent step (third) involves assisting them to do it safely, under close monitoring