Background: Many diabetic patients insist on fasting Ramadan against medical advice. Aim: to assess how fasting Ramadan impacts kidney functions in Egyptian patients with type 2 diabetes. Patients and Methods: the study included 180 individuals fasted Ramadan: divided into 3 equal groups; classified into group I (Non diabetic patients with normal renal functions), group II (diabetic patients without albuminuria) and group III (diabetic patients with micro albuminuria) attending to Menoufia University Hospitals clinics. They were assessed for height, weight, blood pressure, body mass index and investigated for fasting and post prandial blood glucose , hemoglobin a1c, serum urea, creatinine, estimated GFR, and urinary albumin/ creatinine ratio one month before and after Ramadan. Results: A significant decrease in hemoglobin A1c levels was observed in groups II and III and no change in it in Group I. Regarding kidney function tests, group I did not exhibit any significant differences, whereas groups II and III displayed a marked deterioration in these parameters, including serum urea, creatinine, and estimated GFR. No significant change in A/C ratio in Group I, but it decreased in groups II and III. Conclusion: Fasting Ramadan enhanced glycemic regulation in type 2 diabetic patients with no deterioration in kidney functions within group I, however, deterioration was noted in groups II and III. Patients should receive guidance on maintaining proper hydration and adopting healthy dietary changes during the period before Ramadan, and it is also advisable for them to consult their healthcare providers regarding their suitability for fasting.