Living with kidney disease: fasting during Ramadan

People with chronic kidney disease are exempt from fasting during the month of Ramadan, but it can be a difficult decision for Muslims. Kidney patients Rehana and Sumaya share their experiences

Ramadan is an important month for Muslims across the world. It is the ninth month in the Islamic calendar and the dates change each year because the calendar is based on the cycles of the moon. It lasts for 29 or 30 days, depending on the sighting of the moon.

The end of Ramadan is marked by the Eid Al-Fitr celebration. On this day no one fasts, and the day is started with a special Eid prayer. This is followed by visiting family, enjoying foods and giving gifts.

How can kidney disease impact Ramadan?

Ramadan is known as a month of fasting, self-reflection, charity, and spiritual growth.

Fasting (restricting food and drink) starts in the early hours of the morning, from dawn, and lasts throughout the day until sunset. This can be an issue for those celebrating with chronic kidney disease (CKD). When the body fasts for a prolonged period of several hours, glucose levels are affected as the body uses these energy reserves first.

Research on the impact of fasting in kidney patients is limited. Some research suggests that for patients within earlier stages of CKD with a stable kidney function, fasting could be safely undertaken. Other research has indicated that additional factors, such as age, could also influence the safety of fasting for those with CKD. Regardless, it is important that anyone with kidney disease does not undertake any type of fasting without first consulting their doctor or kidney team for guidance.

Ramadan plates of food

Fasting guidelines for people living with kidney disease

Some groups of people are exempt from fasting during Ramadan, including those with certain health conditions such as kidney disease. This means that there is no expectation for those people to fast.

Fasting is always a personal choice, but if you have kidney disease, it is vital that you talk to your kidney team before fasting. They can help you to better understand any risks to your health and to develop a plan to fast safely, if this is an option for you.

"I enjoy the many other things this month brings"
Rehana, kidney patient
Rehana Kosar

Rehana is Ambassador for Bradford Teaching Hospitals. Following her diagnosis and treatment for kidney disease, she was struck by the impact that not being able to fast had on her during Ramadan.

“I was transplanted eight years ago and to me my transplant means everything. It means that I can work, travel, and enjoy independence from dialysis. As a Muslim, Ramadan is a very important time of the year. But this month also brings with it grief and sadness.

“I am unable to fast because I have to take medication, drink plenty of fluids and eat healthy balanced meals throughout the day. And as I begin to accept that I cannot experience this, I’m faced with another challenge.

“During Ramadan, there is an assumption within my community that everyone is fasting. So often, we don’t see Muslims eating or drinking during the day. And as many are not aware that I have had a kidney transplant, I feel I shouldn't have to explain this whenever I get asked the dreaded question of why I am not fasting.

“At times when I’m out, I find myself eating and drinking discreetly, or in quiet places. Because Islam exempts you from fasting if you are ill, I don’t feel bad – I know I still get the reward. Instead, I enjoy the many other things this month brings, such as the development of my soul, self-reflection and giving charity. To my fellow CKD patients who struggle this month, remember we are exempt and enjoy the many other blessings this month brings.”

"Ramadan is more than just refraining from food and drink... I can still pray, self-reflect, and grow spiritually"
Sumaya, kidney patient and Kidney Matters Deputy Editor
Sumaya Masood

Kidney Matters Deputy Editor, Sumaya, reflects on her experience of Ramadan since her kidney disease diagnosis.

“As we draw close to the end of Ramadan, I cannot help the feeling of guilt. I keep asking myself, have I done enough? Have I made the most of this month? Other Muslims like me, who suffer from chronic kidney disease, probably ask themselves the same questions.

“This is because we cannot fast. And although people like me are exempt from fasting, there is a sense of loss.

“My family has always celebrated Ramadan, and it’s something I’ve observed since I was very young. It’s a time for quiet reflection and self-discipline so, after eating suhoor, the early morning meal, I would often pray and read. I would continue my day at school, university, or work, and would see many people eating and drinking around me.

“And although this was difficult, a few days into Ramadan my body started to adjust, and it got easier. By the end of the day, I felt the sense of a personal victory, knowing that I had completed my fast for my spiritual growth. This was not to last, however.

“I was diagnosed with kidney failure in my early twenties, and whilst this was sudden and unexpected, I had no idea how much my life was to change. Now, several years after my diagnosis, I am happy and content, but there is one thing that I have struggled with for many years which is not being able to fast.

“Many people tell you not to let kidney disease take over your life, and whilst I agree, I felt that I was robbed of being able to fast in Ramadan. It was part of my identity, part of my childhood and part of my belief as a Muslim.

“After years of tears, anguish and resentment, I have accepted it. It helped to know that I am exempt from fasting, and that there is no expectation for me to fast. Instead, I learned that I am rewarded in the same way as someone who fasts. Understanding that Ramadan is more than just refraining from food and drink also helped me. I can still pray, self-reflect, and grow spiritually.

“Ramadan also encourages us to act with generosity and give charity. In this month Muslims are obligated to give a portion of their wealth to charity (this is called Zakat); like many others, I take part.

“As we draw closer to the end of Ramadan, not all is doom and gloom. It has been a long tiresome journey to get to where I am today, but I am content with whatever I achieve this month.”

Kidney Kitchen's Ramadan and Eid recipes

  • Talbina

    A warming porridge, ideal for Ramadan, which can be served in many ways but remains low in potassium and low in phosphate.

  • Lamb kebabs

    Homemade lamb kebabs provide plenty of protein without the additives.

  • Chana chaat

    Chana chaat is tangy, fresh and easy to make, with no cooking involved. This savoury version is kidney-friendly and has been designed for those who wish to eat something traditional during Ramadan.