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Ramadan fasting in patients with chronic kidney disease (CKD) should always be individualized. While some patients with early-stage, stable CKD (Stage 1–3) may fast safely under medical supervision, those with advanced CKD (Stage 4–5), frequent high potassium levels, uncontrolled diabetes or blood pressure, recurrent dehydration, or those on dialysis are generally advised not to fast due to the risk of acute kidney injury, hyperkalemia, and worsening kidney function. Before Ramadan, CKD patients should have their kidney function, potassium levels, blood pressure, and medications reviewed by their doctor. During Ramadan, adequate fluid intake between Iftar and Suhoor, avoiding high-potassium foods, and monitoring for warning symptoms such as dizziness, reduced urine output, swelling, or severe weakness are essential. Fasting is exempted in Islam for those with medical illness, and health should always come first. Always consult your nephrologist before deciding to fast.