Kidney Transplant

After kidney a transplant, the metabolic abnormalities associated with uremia and side-effect of dialysis therapy will be corrected. However, the transplant itself and the side effects of the immunosuppressive drugs may affect the diet. The new kidney is considered as “foreign” tissues, to prevent rejection of the transplanted kidney, immunosuppressive drugs are needed. A healthy and balanced diet still plays an important role in maintaining overall health and keeping precious kidney works well. Kidney recipients may be surprised that they need to be on a special diet for a short period of time after the transplant surgery. However, do not worry as a dietitian will coach them on what to do and help them to plan their meals according to their needs. Kidney recipients may find that this diet is easier to follow than the haemodialysis diet because the new kidney will be able to help body to keep a healthy balance of potassium and phosphorus.

Here are some of the important information that you might need to know or equip yourself for transplant

1. Maintain a healthy body weight

Weight gain after kidney transplant is common. Many people have a better appetite after a transplant due to an improved sense of well-being and the steroid medication taken. Maintaining a healthy body weight in the Body Mass Index (BMI) range of 18.5-22.9kg/m² can lower risks of having hypertension, heart problem, diabetes mellitus, and stroke. Weigh yourself regularly, stay active and talk to a dietitian if you need a low-calorie diet.

2. Keep your lipid profile controlled

Dyslipidemia is common among kidney recipients. Elevated level of total cholesterol, low density lipoprotein cholesterol (LDL-cholesterol) and triglycerides increase the risk of heart problems. There are many ways to keep blood cholesterol controlled for a healthy heart. Let’s practice a diet that is

• Low in sodium (salt)
• Low in fat especially saturated fat
• Low in dietary cholesterol
• Minimise in trans fat
• High in dietary fibre

3. Keep your blood pressure controlled

Most kidney recipients still need to limit salt intake, although it is different from each person. Transplant medicines, especially steroids, may cause body to hold on to fluid, and high intake of salt worsens this problem. Controlling blood pressure is very important both before and after transplantation. Doctor will decide how much sodium is best for kidney recipients.

4. Maintain a healthy bone

Rapid decline in bone mineral density occurs in the early stage of kidney transplant. Bone mineral density remains low even the rate of bone loss decelerate or cease   after 3 years of transplant. Reduced calcium absorption due to Prednisone, hyperparathyroidism, abnormal vitamin D metabolism are the potential factors that further weaken the bone. There is an increased risk of bone loss for women, particularly post-menopausal women.

Pay close attention to calcium and phosphorus levels. Doctor will check for possible bone loss and talk to kidney recipients about the best way to keep their bones as healthy as possible. To keep bone healthy, include two servings of dairy products such as low fat milk, cheese and yogurt in daily diet, unless doctor or dietitian has told kidney recipients not to use these foods. Doctor may decide whether kidney recipients need more calcium and phosphorus than their usual diet provides and may tell them to take a supplement. Kidney recipients should not start any supplements on their own as this could cause problems on the new kidney.

5. Prevention of Anemia

Anemia is always common among end stage kidney patients. Anemia can also occur among kidney recipients. Diet lack in iron, folate and/or vitamin B12 may contribute anemia among kidney recipients. Prevention and management of anemia are important in maintaining a good health and reduce the risk of death.

6. Keep your food safe and maintain hygiene

Organ transplant recipients are more susceptible to food borne illness such as listeriosis as a result of their compromised immune system. Kidney recipients should follow the food safety precaution, for example, minimise or reduce raw food consumption like salad, raw fish and so on. Kidney recipients can consult dietitian to learn more about food safety.

Kidney recipients who were on dialysis may have several doubts on diet after transplant.

1. Do I still need to practice high protein diet?

Kidney recipients need a higher protein right after transplant to help build up the muscle tissue that has been broken down by the large doses of steroids. However, your protein needs will be the same as healthy individuals after several months of transplant. Your dietitian will tell you how much protein that you need to consume to fasten your healing process. You can refer nutrition information download corner for the food choices and portion size.

2. Will potassium still bother me?

There is no potassium restriction for kidney recipients as long as their transplant is working well. However, some transplant medicines can increase blood level of potassium, while other medicines may decrease it. If so, you might need to modify your diet according to your potassium level in blood. Regular monitoring is important. You can refer to the list of food for their potassium content from the nutrition information download corner.

3. Do I need special diet if I am a diabetic?

You may be advised to have more protein and less sugar in your diet after transplanted. Work with your doctor and dietitian to keep your diet and blood sugar in good control.

4. Is there any food taboo?

Grapefruit, possibly due to its furanocoumarin content, will alter the metabolism of many of the medications prescribed to the kidney transplant recipients, including cyclosporine, tacrolimus, calcium channel blockers and statins. Therefore, kidney transplant recipients are advised to avoid grapefruit in any form. 

*The above information and recommendations are general guidelines, and should not be viewed as specific advice for any individual. Please consult your physician or other health care advisors for personal health decisions.