What to eat after your transplant

You may wonder if you’ll need a special diet after your transplant. Most people who have a kidney transplant are asked to follow a heart-healthy diet. Good nutrition after your kidney transplant helps you to recover more quickly from the surgery and stay healthy.

A heart-healthy diet limits added sugar, salt (sodium), and fat. Work with your dietitian to help you make healthy food choices and find an eating plan that works for you after your kidney transplant.

These tips can help you develop your own healthy eating habits.

Long-term healthy eating goals

Healthy eating is a lifelong habit. To help you get started try working on one of these tips. Once you’ve done that for a couple of weeks add in another small step toward healthy eating. Soon you’ll be eating a heart-healthy diet as part of your regular routine.

• Space meals and snacks throughout your day.
• Eat a variety of foods from Canada's food guide every day.
• Choose more vegetables and fruit, whole grains and whole grain cereals and breads (see Canada’s food guide).
• Choose lower-fat dairy products, lean meats, and foods prepared with little or no saturated (animal) fat.
• At meals and snacks eat some protein like leaner meat, fish, chicken, legumes, tofu, eggs, peanut butter, or low-fat (skim or 1%) milk products such as milk, yogurt, or cheese.

Promote heart health – Your immunosuppressant (anti-rejection) medicines may make your cholesterol and triglycerides (fats in your blood) higher. You can lower your risk of heart disease and stroke by keeping on with a heart-healthy eating plan. For a review of nutrition tips about healthy eating go to Nutrition before your kidney transplant​. You can also talk to your dietitian about any questions you have or for more tips for healthy eating.

Vitamins and minerals

You may need to change the foods you eat that have certain vitamins and minerals depending on your blood test results. This includes sodium, potassium, phosphorous, magnesium, calcium, and vitamin D.

Sodium (salt) – Limit the amount of salt you eat to help to manage your blood pressure and fluid levels in your body. High blood pressure and fluid retention (extra fluid in your body) are common side effects of immunosuppressant medicines.

To lower the amount of sodium you eat:

• cook and eat food without added salt
• choose fresh, unprocessed, and homemade foods
• flavour your food with herbs, spices, garlic, onion, lemon juice, vinegar, and salt-free seasonings

Potassium – Many different fruits and vegetables have potassium in them. Most people don’t need to limit how much potassium they eat after transplant. However, some transplant medicines may cause your blood level of potassium to go higher or lower. If this happens talk to your dietitian about how much potassium is right for you.

Phosphorous – After your transplant, your blood phosphorus levels may go down. Most people will be asked to eat more foods that have phosphorous after their transplant. If your blood phosphorous level is low, choose foods high in phosphorous. If you’ve been on dialysis, switching from a low phosphorus diet to a high phosphorus diet can be challenging. Talk to your transplant dietitian to help you with making this change.

Foods that contain phosphorus are:

• whole grain foods
• bran cereal
• nuts
• dried beans or lentils
• milk products (low-fat milk, yogurt, cheese)

If your phosphorous level stays low, your transplant team may ask you to take a phosphorous supplement.

Magnesium – Your blood magnesium level may be low after your transplant surgery. If your magnesium level is low, eat more:

• green leafy vegetables
• tofu (firm)
• whole grains
• nuts and seeds
• seafood

If your magnesium level stays low, your transplant team may ask you to take a magnesium supplement.

Calcium and vitamin D – To make sure your bones are strong and to lower your risk of bone disease, it’s important to get enough calcium and vitamin D. Your healthcare team may ask you to eat foods with more calcium and vitamin D. You may even be asked to take a supplement if your levels are too low or if you’re not getting enough from your food every day. To check how strong your bones are you may have a bone density test.

Good sources of calcium:

• milk, 1 cup (250 mL)
• yogurt, ¾ cup (250 mL)
• cheese, 1½ oz. (50 g)
• fortified plant-based beverages like soy, rice, or almond beverages, 1 cup (250 mL)
• canned salmon with bones, 2½ oz. (75 g)

Another important way to keep your bones healthy is to be active every day. Your transplant team can help you find what kinds of activity work best for you.

Fluids

Keeping hydrated and drinking enough fluid is an important way to keep your new kidney healthy. It also helps your body heal and function better. After your transplant, it’s important to drink enough fluid.

• Aim to drink 10 to 12 cups (2½ to 3 L) of fluid each day unless your transplant team suggests other amounts.
• Water is your best choice, but you don’t need to restrict yourself to drinking water only. Drink at least half of your fluid intake as water.
• For drinks other than water, choose those with no added sugar such as low-fat milk or alternatives, sugar-free soft drinks, sugar-free crystal drinks, carbonated water, tea, and coffee.
• Limit regular pop, juice, sweetened iced tea, fruit drinks, or hot chocolate.
• Limit drinks with caffeine like coffee, tea, and colas to 3 to 4 cups (750 mL to1 L) a day.
• If you drink alcohol, please check with your transplant team before drinking any alcohol after your transplant.

Drinking 10 to 12 cups of fluid each day can seem like a lot. Try 1 or more of these tips.

• Always keep a bottle of water with you.
• Store water in the fridge to drink at home.
• Add a lemon or lime wedge to water to keep it tasting fresh. A slice of cucumber works as well if you don’t have lemon or lime.

Healthy body weight

You may find that after your transplant you have a better appetite, a less limited diet, and generally feel better. Most people who have a kidney transplant feel this way. However, as good as this feels it can lead to weight gain. Your immunosuppressant medicines may also cause you to gain weight.

Carrying extra weight may put you at higher risk of high blood pressure, diabetes, and heart disease. It may also put you at higher risk of wound infection and added strain on your transplanted kidney.

If you have questions about your appetite, food choices, or your weight, talk with your transplant dietitian or someone from your transplant team.

Diabetes and nutrition

Food and nutrition are very important to managing diabetes regardless if you had it before your transplant, or you develop it after your transplant.

If you’ve never had diabetes, you may develop high blood glucose (sugar) after your transplant. Some risk factors for high blood glucose after transplant include:

• some transplant medicines
• family history of diabetes
• carrying extra weight
• not being active
• age

Your blood glucose may be managed with food and pills. You may also need to take insulin by needle to control your glucose level. Your transplant team will work with you to manage your diabetes or high blood glucose. In some cases, they may refer you to an expert in diabetes management (endocrinologist). They’ll work with you to help manage your diabetes to lower the risk of problems with your new kidney.

To help you manage your blood glucose level you can:

• manage your weight
• follow healthy food and eating guidelines
• limit sugar and sweet foods
• be active every day

If you develop high blood glucose after your transplant, talk to your kidney transplant team about how to manage your blood glucose level.

Alberta Health Services offers classes to help you manage your diabetes. Contact Health Link at 811 for information about classes in your area.

Food safety

After your kidney transplant, you’ll take immunosuppressant medicines to help keep your kidney working properly. When your immune system is suppressed or weakened, it can make it difficult for your body to fight off infection. Your risk of infection is higher in the first few months after your transplant.

Food can cause infection if proper food safety guidelines aren’t followed. Food can carry bacteria, viruses, fungi, and parasites. You can help prevent food-borne illness if you follow some simple guidelines.

• Wash your hands, cutting boards, counters, and utensils often when you prepare food.
• Keep raw and cooked foods apart.
• Store food carefully – keep cold foods cold and hot foods hot.
• Avoid unpasteurized milk, cheese, and juices. Make sure meat, poultry, fish, and eggs are thoroughly cooked before eating.
• Avoid sashimi, sushi, steak tartar, or any other dish made with raw fish or meat.
• Don’t buy or use foods near the “best before” date or past that date.