eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2026-03-20 19 1 719 737 10.13005/bpj/3387 70720 article Hala Sabry Alsaedy 1 Ragaa Ramadan Mohamed 1 Mai Elsaied Abdelal 1 Alshaymaa Abd Elbadie Abd Elalim 2 Eman Refaat Youness 3 Ahmed El-Sisi 4 Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Egypt Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Egypt. Medical biochemistry Department, National Research Center, Egypt Department of Internal Medicine and nephrology, Institute of Urology and Nephrology, El-Mataria, Egypt This prospective cohort study evaluated the impact of Ramadan fasting on 162 patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) on regular hemodialysis. Participants were categorized based on fasting behavior and renal status. Biochemical and clinical parameters were assessed before, during, and after Ramadan. Results indicated that fasting was generally well-tolerated, though significant transient increases in blood urea, potassium, and phosphate were observed during fasting periods, particularly among ESRD patients fasting on dialysis days. Serum sodium and eGFR showed significant declines over time in both fasting and non-fasting CKD groups. No adverse effects on albumin or creatinine stability were noted in appropriately supervised patients. The study concludes that Ramadan fasting can be safe for stable CKD and ESRD patients with careful monitoring, dietary management, and individualized medical supervision to mitigate metabolic fluctuations. https://biomedpharmajournal.org/vol19no1/effect-of-ramadan-fasting-on-chronic-kidney-disease-patients/ Chronic Kidney Disease End-Stage Renal Disease Fasting Hemodialysis Ramadan