Patients with kidney disease have been advised to take precautions if they choose to fast during the holy month of Ramadan, Dr Hassan al-Malki, senior consultant of nephrology and transplant at Hamad Medical Corporation (HMC), has advised.
Chronic Kidney Disease (CKD), a long-term condition involving the gradual loss of kidney function, can be categorised into five stages based on severity. CKD affects about 13% of Qatar’s population.
“The category of severity of a patient’s kidney disease can indicate if he or she will be able to fast safely. Patients with acute kidney failure should not fast until they fully recover. However, CKD patients have different stages of nephropathy and patients diagnosed with stage-three CKD or higher are advised not to fast as their kidneys fail to retain normal body fluid levels, making them susceptible to further renal dysfunction and renal damage,” Dr al-Malki cautioned. 
He stressed that abstaining from food and water for long periods could lead to dehydration. CKD patients should consult their physician to assess the severity of their condition and any potential risks associated with fasting.
“Hemodialysis patients typically undergo dialysis three times per week and cannot fast during this time due to the IV fluid intake that takes place during the procedure; however, these patients can fast the rest of the week,” Dr al-Malki added.
He also advised kidney transplant patients to refrain from fasting to comply with their prescribed medication dosages and times. As many kidney transplant patients are diabetic, fasting may have a negative impact on their health. Therefore, it is imperative that these patients consult their physician before deciding to fast.
Ayman Alawneh, HMC dietitian, emphasised that patients with kidney disease must consult their dietitian to ensure adequate protection against potential complications while fasting. He noted that many kidney disease patients tend to overlook the importance of maintaining a healthy and balanced diet while fasting. 
“Patients suffering from kidney disease should not skip Suhoor (pre-dawn meal) to avoid feeling weak, bearing in mind that they need more calories than individuals in good health. Kidney disease patients should be careful not to ingest high quantities of sodium, potassium and phosphorus, especially during Ramadan,” he noted.   
According to him, each kidney disease has its own dietary requirements for Ramadan. “If physicians approve fasting for pre-dialysis kidney patients, they should maintain a diet low in protein-rich foods to avoid imposing an extra burden on their kidneys. This could lead to complete renal failure and increase the level of urea in their system,” he advised. 
He advised them to avoid spending a significant amount of time outside in high temperatures when they are fasting, adding that they should also avoid eating salty foods. 
Meanwhile, the HMC has urged patients with kidney disease who experience any difficulties while fasting to seek urgent professional advice or dial 999 for the ambulance service.