paladin181: Vampire the Masquerade: Redemption is set in a "real world setting." Though religion is barely mentioned in passing there. It's also not medieval (after a short time) nor fantasy.
He was faster than me. I second that. It has a nice mix of jewish apocrypha (13 clans, the lilith figure, kabalistic sorcery), real world superstition (gypsy woman selling charms and "seeing" things for instance) plus real reference to historic sects and major religions (pagan barbarians, knights of st john, teutonic order, christianity, crusades/crusaders). All of them bent in a semi fantasy setting, though. I mean, don't expect with real kabbalistic "art" to animate a golem or something, don't expect with real treatises on necromancy to "raise" skeletons, zombies and specters etc. It brings a nice feeling with the lore about kain, the incoming apocalypse, the gloom and doom and so on. Feels like a darker, crazier, loonier version of real world paranoia- sorry, i mean religion and sect teachings...
Tremere dungeons, alchemical research, corpses and "divining the future from ripped entrails" (as a tremere himself suggests in game, and as that once had been a real divinatory method), had a nice touch of macabre disgust, as well. You can't go wrong with this one. Highly recommended.