After undergoing a kidney transplant, the acute transplant period after your operation lasts for up to eight weeks. It increases your need for protein and overall calories due to medications and postoperative stress. Therefore, certain changes in diet are important for people with chronic kidney disease (CKD) who have recently had a kidney transplant.*

Why is changing diet important?

To understand why dietary changes after a kidney transplant are important, a great example is protein. A higher protein intake is needed to help build and repair muscle tissue that will be broken down by the large doses of steroid medications taken by postoperative patients. 

High-quality proteins include:

• Meat
• Chicken
• Fish
• Milk
• Yogurt
• Cheese
• Eggs
• Peanut butter
• Beans
• Peas

What other nutrients in my diet may change? 

Your transplant team may recommend that you modify your consumption of certain nutrients, such as carbohydrates, potassium, and sodium, for various reasons. 

Blood glucose

Blood glucose levels can become elevated and increase your risk of developing glucose intolerance after transplantation. This can increase a person’s risk for prediabetes or diabetes. Regulating blood glucose levels and avoiding uncontrolled glucose levels can prevent graft loss (i.e., transplant failure), infection, and cardiovascular disease.

Blood glucose can be managed through a carbohydrate-controlled diet and exercise, along with insulin or oral medications if prescribed.

Fluid and sodium

Fluid and sodium restrictions are determined case by case. Some patients don’t need to restrict how much they drink. Patients who are prescribed transplant medicines, such as steroids, however, may retain excess fluid and need to watch what they drink and how much sodium they consume. 

Sodium can increase fluid retention, and increased fluid in the body can raise your blood pressure. Therefore, a doctor may recommend that patients limit high-salt foods, such as sausage, ham, pre-packaged frozen dinners, pickled foods, and canned soups.

Potassium

Certain transplant medicines can cause potassium levels to increase while others may decrease levels. Your transplant team will monitor potassium levels and provide education on high potassium-containing foods to either consume or to avoid, such as:

• Oranges
• Bananas
• Tomatoes and tomato products, like pizza and spaghetti sauces
• Potatoes
• Milk
• Yogurt

Phosphorus

Phosphorus levels often drop low post-transplant, so restricting intake isn’t necessary. High-phosphorus foods can be enjoyed to maintain proper bone health. For some people, food sources of phosphorus may not be enough to increase phosphorus to normal levels, and a phosphorus supplement is needed.

Researcher shows that CKD may cause bone loss, and when coupled with the corticosteroids taken after a transplant, further bone loss could occur. In addition to phosphorus, adequate calcium and vitamin D intake are crucial to keeping bones healthy. It is recommended to eat two servings of dairy daily, such as low-fat milk, cheese, and yogurt. Additionally, your doctor may recommend calcium and vitamin D supplements.

Why is food safety extra important?

Your transplant team may recommend avoiding certain foods that pose a high risk for contracting a foodborne illness when taking immunosuppressive drugs. This type of medication helps prevent the rejection of a new organ, but consequently, it also decreases immune function.

These foods include:

• Raw or undercooked eggs
• Raw or undercooked pork, beef, chicken, fish, shellfish (sushi)
• Unwashed raw fruits or vegetables
• Unpasteurized milk, cheese, and yogurts
• Sliced deli meats and cheeses

It’s also important to engage in proper food handling practices, such as:

• Using different cutting boards and knives for raw meats versus produce
• Avoiding eating leftovers left at room temperature
• Ensuring foods are cooked at proper internal temperatures prior to consumption

*Alsing, S. (2020, Oct. 13). What to Eat after Kidney Transplant, Part 1.Davita. https://blogs.davita.com/kidney-diet-tips/what-to-eat-after-kidney-transplant-part-1/