Ramadan has begun. It is a month of spiritual pursuit, and during this time, Allah Ta'ala has obliged fasting for healthy and active individuals. However, many people are unable to fast due to various diseases, and kidney disease is one such condition that creates hesitation regarding fasting. Kidney disease is one of the most prevalent illnesses in today's world, and the number of kidney patients is steadily increasing worldwide. This disease affects more women than men, and in Bangladesh, the incidence of kidney disease is growing every day. A person can be sure of having kidney disease only when the function of both kidneys is reduced by 60 to 70 percent.
There are various types of kidney disease. Those with good kidney function despite kidney disease may still be able to fast according to normal rules. Some of the essential functions of the kidneys include eliminating body waste or toxins, maintaining the balance of water and electrolytes in the body, and controlling blood pressure. Extensive research has been conducted on the fasting of kidney patients. The primary concerns for kidney patients are dehydration and renal hypoperfusion, both of which can lead to the deterioration of kidney function.
Diabetes is the primary cause of long-term kidney disease, followed by high blood pressure and kidney inflammation. Fasting can pose risks to kidney patients, such as dehydration, hypertension, and electrolyte imbalance. Additionally, patients with diabetes may face the risk of low blood sugar levels, leading to hypoglycemia. These issues can further reduce kidney function and sometimes cause acute kidney injury (AKI) or sudden kidney failure. In some cases, these problems can be fatal.
For patients who have undergone kidney replacement, lifelong medications and adherence to specific rules are necessary. Various studies suggest that dehydration and hypoperfusion can lead to a decline in kidney function. If fasting lasts for more than 12 hours, patients may need to adjust their medication dosage and the formula of drugs like tacrolimus and MMF. Most studies show no significant difference in fasting during Ramadan, but it is generally not advisable for individuals with moderate to severe kidney function deterioration to fast.
For kidney patients, especially those in the fifth stage of kidney failure, those who require regular dialysis, or those undergoing treatment for urinary tract issues, fasting can be risky. If a chronic kidney patient has complications with blood components, or if they suffer from uncontrolled diabetes or high blood pressure, fasting may not be suitable.
Fruits such as apples, ripe papaya, ripe guava, pineapple, jamrul, ripe jackfruit, raw mango, and ripe bell fruit are suitable in moderate quantities. Additionally, rice, flour, semai, semolina, barley, cornflakes, and cornflower are helpful in a kidney patient's diet.
It is important to remember that the current hot weather makes street food prone to contamination, which can lead to infections like diarrhea and vomiting. These conditions can disrupt the health of kidney patients. Therefore, it is essential to avoid such foods. Even if the rest of the family follows the same diet during Ramadan, kidney patients should follow a separate, tailored diet plan to ensure their health. As for medication, it is recommended that morning medication be taken during Sahari and night medication during Iftar. If possible, the morning medication should be taken with a light meal during Sahari.
Finally, it is essential to understand that fasting is a blessing and a form of discipline prescribed by Allah for the welfare of His servants. Allah has set clear rules for fasting, and fasting should be observed accordingly. Although many kidney patients may be concerned about fasting with their condition, it is important to be aware and seek treatment, including homeopathic remedies, for various health issues. Life should be lived in a state of health and well-being, and fasting is a means of seeking Allah's favor. May Allah grant us all the strength to fast in good health.
The writer is a founder and Chairman, Jatiya Rogi Kallyan Society
